探讨肝硬化食管胃静脉曲张破裂出血（EVB）患者术前多层螺旋CT血管造影（MSCTA）影像学特征、中性粒细胞与淋巴细胞比值（NLR）、Glasgow-Blatchford评分（GBS）、内镜前Rockall评分（PRS）和AIMS65评分变化及其对预后的预测价值。

回顾性选取宝鸡高新医院2022年1月至2024年8月收治的100例肝硬化EVB患者作为研究对象，所有患者均接受内镜下食管静脉曲张套扎、套扎联合硬化剂注射或介入栓塞等治疗，术前完善MSCTA检查。两组患者出院后随访6个月，根据患者预后生存情况，分为存活组（n=88）和死亡组（n=12）。比较两组手术前MSCTA影像学特征[胃左静脉（LGV）、门静脉主干（MPV）、肠系膜上静脉（SMV）、脾静脉（SPV）的最大横径]、NLR、GBS、PRS和AIMS65评分。采用Pearson相关分析法分析肝硬化EVB患者影像学特征、NLR、GBS、PRS、AIMS65评分与预后的相关性，采用受试者工作特征曲线（ROC）评价MSCTA影像学特征、NLR、GBS、PRS、AIMS65评分对肝硬化EVB患者预后的预测价值。

死亡组患者LGV、MPV、SMV、SPV的最大横径，NLR值，GBS、PRS、AIMS65评分均明显高于存活组（P<0.05）；肝硬化EVB患者LGV、MPV、SMV、SPV、NLR及GBS、PRS、AIMS65评分与预后均呈正相关（P<0.05）。ROC曲线分析结果显示，LGV、MPV、SMV、SPV、NLR及GBS、PRS、AIMS65评分的曲线下面积分别为0.837、0.675、0.695、0.861、0.694、0.857、0.974、0.972，敏感度分别为0.750、0.500、0.583、0.667、0.667、0.917、0.833、0.917，特异性分别为0.989、0.841、0.773、0.955、0.773、0.682、0.989、0.989（P<0.05）。

术前MSCTA影像特征，NLR值及GBS、PRS、AIMS65评分系统能有效预测肝硬化EVB患者预后，综合应用这些指标可提高预后评估准确性，优化治疗方案，改善患者生存率。

To investigate the imaging features of preoperative multislice CT angiography (MSCTA), neutrophil to lymphocyte ratio (NLR), Glasgow-Blatchford score (GBS), pre-endoscopic Rockall score (PRS) and AIMS65 score changes and their prognostic significance in patients with esophageal and gastric variceal bleeding (EVB) due to cirrhosis.

A total of 100 liver cirrhosis patients with EVB admitted to Baoji High-tech Hospital from January 2022 to August 2024 were included as study objects, all patients received treatments such as endoscopic esophageal variceal ligation, ligation combined with sclerotherapy injection or interventional embolization, and completed MSCTA examination before the operation. The two groups of patients were followed up for 6 months, according to the prognosis and survival status of the patients, they were divided into the survival group (n=88) and the death group (n=12). Preoperative MSCTA imaging features [maximum transverse diameters of left gastric vein (LGV), main portal vein (MPV), superior mesenteric vein (SMV) and splenic vein (SPV)], NLR, GBS, PRS and AIMS65 scores were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between imaging features, NLR, GBS, PRS, AIMS65 scores and prognosis of EVB patients with cirrhosis. Receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of MSCTA imaging features, NLR, GBS, PRS and AIMS65 scores in EVB patients with cirrhosis.

The maximum transverse diameters of LGV, MPV, SMV, SPV, NLR, GBS, PRS and AIMS65 scores in the death group were significantly higher than those in the survival group (P<0.05). LGV, MPV, SMV, SPV, NLR, GBS, PRS, AIMS65 were positively correlated with the prognosis of EVB patients with cirrhosis (P<0.05); ROC curve analysis results showed that the area under the curve (AUC) of LGV, MPV, SMV, SPV, NLR, GBS, PRS and AIMS65 were 0.837, 0.675, 0.695, 0.861, 0.694, 0.857, 0.974 and 0.972. The sensitivity was 0.750, 0.500, 0.583, 0.667, 0.667, 0.917, 0.833, 0.917, and the specificity was 0.989, 0.841, 0.773, 0.955, 0.773, 0.682, 0.989, 0.989 (P<0.05).

Preoperative MSCTA imaging features, NLR and GBS, PRS, AIMS65 scoring systems can effectively predict the prognosis of EVB patients with cirrhosis, the comprehensive application of these indicators can improve the accuracy of prognosis assessment, optimize treatment plan, and improve the survival rate of patients.