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spleen volume is associated with overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with portal hypertension

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2054-2064页

作者： Chun-Juan Zhao Chao Ren Zhen Yuan Guo-Hui Bai Jin-Yu Li Long Gao Jin-Hui Li Ze-Qi Duan Dui-Ping Feng Hui Zhang College of Medical Imaging Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina Department of Radiology The First Hospital of Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina Department of Occupational Health School of Public HealthShanxi Key Laboratory of Environmental Health Impairment and PreventionNHC Key Laboratory of PneumoconiosisMOE Key Laboratory of Coal Environmental Pathogenicity and PreventionShanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina Department of Oncological and Vascular Intervention The First Hospital of Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina Shanxi Provincial Clinical Research Center for Interventional Medicine The First Hospital of Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina First Clinical Medical College Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine The First Hospital of Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province The First Hospital of Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina

BACKGROUND Portal shunt and immune status related to the spleen are related to the occurrence of hepatic encephalopathy(HE).It is unknown whether spleen volume before transjugular intrahepatic portosystemic shunt(TIPS)is related to postoperative *** To investigate the relationship between spleen volume and the occurrence of *** This study included 135 patients with liver cirrhosis who underwent TIPS,and liver and spleen volumes were elevated upon computed tomography *** Kaplan-Meier curve was used to compare the difference in the incidence rate of HE among patients with different spleen *** and multivariate Cox regression analyses were performed to identify the factors affecting overt HE(OHE).Restricted cubic spline was used to examine the shapes of the dose-response association between spleen volumes and OHE *** The results showed that 37(27.2%)of 135 patients experienced OHE during a 1-year follow-up *** with preoperative spleen volume(901.30±471.90 cm3),there was a significant decrease in spleen volume after TIPS(697.60±281.0 cm^(3))in OHE *** the severity of OHE increased,the spleen volume significantly decreased(Pspleen volume≥782.4 cm^(3),those with a spleen volumespleen volume was an independent risk factor for post-TIPS OHE(hazard ratio=0.494,Pspleen volume,OHE risk showed an initial increase and then decrease(Pspleen volume is related to the occurrence of OHE after *** spleen volume is an independent risk factor for post-TIPS OHE.

关键词： Hepatic encephalopathy Transjugular intrahepatic portosystemic shunt spleen volume Portal hypertension Cirrhosis

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Non-invasive model for predicting esophageal varices based on liver and spleen volume

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World Journal of Clinical Cases 2022年第32期10卷 11743-11752页

作者： Long-Bao Yang Gang Zhao Xin-Xing Tantai Cai-Lan Xiao Si-Wen Qin Lei Dong Dan-Yan Chang Yuan Jia Hong Li Department of Gastroenterology The Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina Department of Medicine Xi'an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina

BACKGROUND Upper endoscopy is the gold standard for predicting esophageal varices in *** and consensus suggest that patients with liver cirrhosis should undergo periodic upper endoscopy,most patients undergo their first upper endoscopy when esophageal variceal ***,it is important to develop a non-invasive model to early diagnose esophageal *** To develop a non-invasive predictive model for esophageal varices based on liver and spleen volume in viral cirrhosis *** We conducted a cross-sectional study based on viral cirrhosis crowd in the Second Affiliated Hospital of Xi'an Jiaotong *** collecting the basic information and clinical data of the participants,we derived the independent risk factors and established the prediction model of esophageal *** established model was compared with other *** under the receiver operating characteristic curve,calibration plot and decision curve analysis were used to test the discriminating ability,calibration ability and clinical practicability in both the internal and external *** The portal vein diameter,the liver and spleen volume,and volume change rate were the independent risk factors of esophageal *** successfully used the factors to establish the predictive model[area under the curve(AUC)0.87,95%CI:0.80-0.95],which showed better predictive value than other *** model showed good discriminating ability,calibration ability and the clinical practicability in both modelling group and external validation *** The developed non-invasive predictive model can be used as an effective tool for predicting esophageal varices in viral cirrhosis patients.

关键词： Gastroscopy Esophageal varices Liver volume Cirrhosis Non-invasive diagnostic model spleen volume

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Non-invasive prediction model for high-risk esophageal varices in the Chinese population

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World Journal of Gastroenterology 2020年第21期26卷 2839-2851页

作者： Long-Bao Yang Jing-Yuan Xu Xin-Xing Tantai Hong Li Cai-Lan Xiao Cai-Feng Yang Huan Zhang Lei Dong Gang Zhao Department of Gastroenterology The Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina

BACKGROUND There are two types of esophageal varices(EVs):high-risk EVs(HEVs)and lowrisk EVs,and HEVs pose a greater threat to patient life than low-risk *** diagnosis of EVs is mainly conducted by gastroscopy,which can cause discomfort to patients,or by non-invasive prediction models.A number of noninvasive models for predicting EVs have been reported;however,those that are based on the formula for calculation of liver and spleen volume in HEVs have not been *** To establish a non-invasive prediction model based on the formula for liver and spleen volume for predicting HEVs in patients with viral *** Data from 86 EV patients with viral cirrhosis were *** liver and spleen volumes of the patients were determined by computed tomography,and their calculated liver and spleen volumes were calculated by standard *** imaging and biochemical data were *** impact of each parameter on HEVs was analyzed by univariate and multivariate analyses,the data from which were employed to establish a non-invasive prediction *** the established prediction model was compared with other previous prediction ***,the discriminating ability,calibration ability,and clinical efficacy of the new model was verified in both the modeling group and the external validation *** Data from univariate and multivariate analyses indicated that the liver-spleen volume ratio,spleen volume change rate,and aspartate aminotransferase were correlated with *** indexes were successfully used to establish the noninvasive prediction *** comparison of the models showed that the established model could better predict HEVs compared with previous *** discriminating ability,calibration ability,and clinical efficacy of the new model were *** The non-invasive prediction model for predicting HEVs in patients with viral cirrhosis was successfully *** new model is reliable for predicting HEV

关键词： Cirrhosis High-risk esophageal varices Non-invasive prediction model Liver volume spleen volume

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