探讨彩色多普勒超声（CDUS）检测门静脉充血指数（PV-CI）及脾静脉血流动力学参数[脾静脉主干内径（SVD）、脾静脉平均血流速度（SVV）、脾静脉血流量（SVQ）]在肝硬化食管胃底静脉曲张（EGFV）风险评估中的临床价值。

回顾性分析陕西省核工业二一五医院2022年3月至2025年3月收治的70例肝硬化患者临床资料，患者均行CDUS检查测定PV-CI、SVD、SVV及SVQ，行胃镜检查明确是否存在EGFV，并评估EGFV程度。根据胃镜结果分为EGFV组（n=42）与无EGFV组（n=28），EGFV组按曲张程度分为轻度组（n=15）、中度组（n=17）、重度组（n=10）。随访12个月记录EGFV组中食管胃静脉曲张破裂出血（EVB）情况，分为出血组（n=25）与未出血组（n=17）。对比各组参数差异，采用受试者工作特征曲线（ROC）分析各参数及联合对EVB的评估效能。

EGFV组PV-CI、SVD、SVQ均显著高于无EGFV组，SVV显著低于无EGFV组（P<0.05）；随EGFV程度加重，PV-CI、SVD、SVQ逐渐升高，SVV逐渐降低，重度组与轻、中度组差异均有统计学意义（P<0.05）；出血组PV-CI、SVD、SVQ均显著高于无EGFV组，SVV显著低于未出血组（P<0.05）。ROC曲线显示，PV-CI、SVD、SVQ、SVV联合评估EVB的曲线下面积（AUC）、敏感度、特异度均显著高于各指标单独检测（P<0.05）。

CDUS检测的PV-CI及脾静脉血流动力学参数与肝硬化EGFV发生、严重程度及EVB风险密切相关，联合评估可提高EGFV风险预测效能，为临床提供无创、便捷的评估参考依据。

To explore the clinical value of color Doppler ultrasound (CDUS) detection of portal vein congestion index (PV-CI) and splenic vein hemodynamic parameters [main splenic vein diameter (SVD), mean splenic vein velocity (SVV), and splenic vein blood flow volume (SVQ)] in the risk assessment of esophageal and gastric fundus varices (EGFV) in liver cirrhosis.

A retrospective analysis was conducted on the medical records of 70 patients with liver cirrhosis admitted to NO. 215th Hospital of Shaanxi Nuclear Industry from March 2022 to March 2025. All underwent CDUS examination to measure PV-CI, SVD, SVV, and SVQ, and gastroscopy was performed to confirm the presence of EGFV and assess its severity. Based on endoscopic findings, patients were categorized into an EGFV group (n=42) and a non-EGFV group (n=28), the EGFV group was further subdivided by variceal severity into mild group (n=15), moderate group (n=17), and severe group (n=10). The EGFV group underwent 12-month follow-up to record esophageal and gastric variceal bleeding (EVB), categorizing patients into bleeding group (n=25) and non-bleeding group (n=17). Differences in parameters across groups were compared. Receiver operating characteristic (ROC) curve analysis was used to evaluate the efficacy of individual parameters and combined assessment in predicting EVB.

The PV-CI, SVD and SVQ in the EGFV group were significantly higher than those in the non-EGFV group, and the SVV was significantly lower than that in the non-EGFV group (P<0.05); the aggravation of EGFV degree, PV-CI, SVD and SVQ gradually increased, while SVV gradually decreased, there were statistically significant differences between the severe group and the mild and moderate groups (P<0.05); the PV-CI, SVD and SVQ in the bleeding group were significantly higher than those in the non-EGFV group, and the SVV was significantly lower than that in the non-bleeding group (P<0.05); the ROC curve showed that the area under the curve (AUC), sensitivity and specificity of the combined assessment of EVB by PV-CI, SVD, SVQ and SVV were significantly higher than those detected separately by each index (P<0.05).

The PV-CI and splenic venous hemodynamic parameters detected by CDUS are closely related to the occurrence, severity and EVB risk of liver cirrhosis EGFV, the combined assessment can improve the predictive efficiency of EGFV risk and provide a non-invasive and convenient assessment reference basis for clinical practice.