Platelet count can predict the grade of esophageal varices in cirrhotic patients

<b>Background: </b>Bleeding from esophageal varices is a life threatening complication in cirrhosis. Screening endoscopy is therefore recommended in cirrhotic patients to identify patients at risk of variceal hemorrhage. Screening endoscopy is however an invasive procedure and has limitations. Various clinical and biochemical predictors have been studied to predict the existence and grade of esophageal varices in cirrhotic patients. Thrombocytopenia (platelet count &lt;150,000 /uL) is one of those. Patients with large esophageal varices were found to have a lower platelet count. We conducted this study to determine correlation between platelet count and grades of esophageal varices in our population.<b></b> <b>Materials and Methods:</b> This cross sectional study was conducted at the Department of Medicine, POF Hospital, Wah Cantt from 1^st October, 2017 to 30^th May, 2018. Newly diagnosed cases of cirrhosis having varices of any grade on endoscopy were included in study. Endoscopic findings of patients were standardized by using Paquet grading system. On the basis of platelet count patients were divided into 4 sub groups. All data was entered and analyzed using SPSS version 19.0. Platelet count groups were correlated with grading of esophageal varices by using Spearman rank correlations, p value ≤ 0.05 was considered significant. Chi Square test was used to see association between the platelet count and grade of esophageal varices, p value &lt; or = 0.05 was considered significant. <b>Results: </b>Total 110 patients were included in the study, 55.5% (n=61) were male whereas 44.5% (n=49) were female. Mean Platelet count was 213884.62 /mm³ in patients with grade I varices, whereas it was 119518.52, 58386.49 and 21600.00 in patients with grade II,III and grade IV varices respectively (p value= <b>Conclusion: </b>Platelet count can predict the grade of esophageal varices in cirrhotic patients. There is significant negative correlation between the platelet count and grades of esophageal varices.<b></b>

<b>研究背景：</b>食管静脉曲张破裂出血（Bleeding from esophageal varices）是肝硬化（cirrhosis）的致死性并发症。因此，临床推荐对肝硬化患者实施筛查性内镜检查，以识别存在曲张静脉出血风险的人群。然而，筛查性内镜检查属于侵入性操作，存在一定局限性。既往已有多项研究探索用于预测肝硬化患者食管静脉曲张存在与否及分级的临床与生化预测指标，血小板减少症（Thrombocytopenia，血小板计数＜150000/μL）即为其中之一。现有研究显示，合并大型食管静脉曲张的患者血小板水平更低。本研究旨在明确本研究人群中血小板计数与食管静脉曲张分级之间的相关性。<b></b> <b>材料与方法：</b>本研究为横断面研究，于2017年10月1日至2018年5月30日期间在瓦赫坎特POF医院内科开展。本研究纳入经内镜检查确诊存在任一等级食管静脉曲张的新发肝硬化患者。采用Paquet分级系统（Paquet grading system）对患者的内镜检查结果进行标准化分级。依据血小板计数将受试者分为4个亚组。所有数据均通过SPSS 19.0统计软件进行录入与分析。采用Spearman秩相关分析（Spearman rank correlations）探讨血小板计数亚组与食管静脉曲张分级的相关性，以P值≤0.05作为差异具有统计学意义的判定标准；采用卡方检验（Chi Square test）分析血小板计数与食管静脉曲张分级的关联，同样以P值≤0.05为差异具有统计学意义。<b>研究结果：</b>本研究共纳入110例患者，其中男性61例，占比55.5%；女性49例，占比44.5%。I级食管静脉曲张患者的平均血小板计数为213884.62/mm³，II级、III级及IV级食管静脉曲张患者的平均血小板计数分别为119518.52/mm³、58386.49/mm³与21600.00/mm³（P值=）<b>研究结论：</b>血小板计数可用于预测肝硬化患者的食管静脉曲张分级。血小板计数与食管静脉曲张分级之间存在显著的负相关关系。