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摘要：
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摘要：目的 筛选无创性预测丙型肝炎肝硬化患者食管静脉曲张的指标，建立Logistic回归模型，并探讨
该模型的应用价值。方法 回顾性分析2005年1月至2016年1月首都医科大学附属北京地坛医院收治的110
例丙型肝炎肝硬化患者的临床资料，根据胃镜结果将患者分为无食管静脉曲张组和食管静脉曲张组。
采用非条件Logistic回归模型分析患者的临床特点、超声检查结果和生物化学指标，筛选无创预测食管
静脉曲张的指标，在此基础上建立回归模型。另选取2016年2月至2018年2月就诊于首都医科大学附属北
京地坛医院的丙型肝炎肝硬化初治患者，随访1年，验证该模型的阳性预测值及阴性预测值。结果 单因
素分析表明，无食管静脉曲张组和食管静脉曲张组患者的白蛋白、凝血酶原时间、血小板和脾长差异
有统计学意义（P ＜ 0.05）。多因素非条件Logistic回归分析表明，脾长、血小板及凝血酶原时间可有
效预测食管静脉曲张。Logistic回归模型为Y = -1.053 + 1.644 × 凝血酶原时间（s）+ 2.030 × 脾长（cm）-
1.573× 血小板（× 10 9 /L）。该模型对食管静脉曲张的预测灵敏度为83.55%，特异度为87.04%，阴性预测
值为87.5%，阳性预测值为87.5%。结论 血小板、脾长和凝血酶原时间可预测丙型肝炎肝硬化患者食管
静脉曲张的存在。
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Abstract: Objective To investigate non-invasive predictors of esophageal varices (EV) in patients with hepatitis
C-associated liver cirrhosis, to establish a Logistic regression model and to explore the application value of the
model. Methods Clinical data of 110 patients with hepatitis C-associated cirrhosis in Beijing Ditan Hospital,
Capital Medical University from January 2005 to January 2016 were retrospectively analyzed. The patients
were divided into esophageal varices (EV) group and non-EV group according to gastroscopy results. The non-
conditional Logistic regression model was used to analyze the clinical characteristics, ultrasound results and
biochemical indexes of the patients, the non-invasive indexes for predicting esophageal varices were screened,
and the regression model was established on the basis of this model. Results Univariate analysis showed that
there were significant differences in albumin, prothrombin time, platelet and spleen length between patients
with and without esophageal varices (P ＜ 0.05). Multivariate conditional Logistic regression analysis showed
that splenic length, platelet and prothrombin time could effectively predict esophageal varices. The logistic
regression model was Y = -1.053 + 1.644 × prothrombin time (s) + 2.030 × spleen length (cm) - 1.573 × platelets (×
10 9 /L). The sensitivity was 83.55%, the specificity was 87.04%, the negative predictive value was 87.5% and the
positive predictive value was 87.5%. Conclusions Platelet, splenic length and prothrombin time can predict the
presence of esophageal varices in patients with hepatitis C-associated cirrhosis.
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