Research progress on Baveno index for the screening of risk of portal hypertensive bleeding and analysis on its application prospect in advanced schistosomiasis
1. Department of Medical Parasitology, School of Basic Medical Science, Central South University, Changsha, Hunan 410013, China; 2. Hunan Institute of Schistosomiasis Control, Yueyang, Hunan 414000, China; 3. National Key Clinic of Schistosomiasis, Yueyang, Hunan 414000, China; 4. Hunan Provincial Key Laboratory of Immunology and Transmission Control on Schistosomiasis, Yueyang, Hunan 414000, China; 5. Department of Pathology, Hunan Aerospace Hospital, Changsha, Hunan 410006, China; 6. The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
Abstract:Portal hypertension is the main cause affecting the clinical prognoses of more than seven million cirrhotic patients in China, and rupture and bleeding from gastroesophageal varices is the most common fatal complication. Therefore, it is particularly urgent to establish and improve the risk screening and management system for portal hypertensive bleeding. Baveno consensus is the most authoritative international guideline for clinical diagnosis of portal hypertension, and Baveno index (including hepatic venous pressure gradient, liver hardness measurement, platelet count and endoscopy) based on Baveno consensus has important clinical guiding significance for the screening and detection of portal hypertension and gastroesophageal varices bleeding. This review summarizes the research and application progress on Baveno index for the screening of risk of portal hypertensive bleeding so as to better understand the strengths and weaknesses of all the indexes and the current research status in this field and provide references for optimizing and developing more effective screening methods and indexes, especially for the screening of risk of portal hypertension bleeding in patients with advanced schistosomiasis.
黄帅钦, 侯循亚, 管洁, 丁国建, 陈鸿志, 邓维成, 吴翔. Baveno指标在门静脉高压出血风险筛查中的研究进展及其在晚期血吸虫病中的应用前景分析[J]. 实用预防医学, 2022, 29(11): 1405-1409.
HUANG Shuai-qin, HOU Xun-ya, GUAN Jie, DING Guo-jian, CHEN Hong-zhi, DENG Wei-cheng, WU Xiang. Research progress on Baveno index for the screening of risk of portal hypertensive bleeding and analysis on its application prospect in advanced schistosomiasis. , 2022, 29(11): 1405-1409.
[1] Qi X,Berzigotti A,Cardenas A,et al. Emerging non-invasive approaches for diagnosis and monitoring of portal hypertension[J]. Lancet Gastroenterol Hepatol, 2018, 3(10):708-719. [2] Iwakiri Y,Trebicka J. Portal hypertension in cirrhosis: pathophysiological mechanisms and therapy[J]. JHEP Rep, 2021, 3(4):100316. [3] Zanetto A, Shalaby S, Feltracco P, et al. Recent advances in the management of acute variceal hemorrhage[J]. J Clin Med, 2021, 10(17):3818. [4] 马军,李建生,段芳龄. Baveno IV门脉高压诊断和治疗共识[J]. 胃肠病学和肝病学杂志,2007,16(1):22-24. [5] de Franchis R,杨力. 最新门脉高压共识(Baveno V版)[J]. 临床肝胆病杂志,2011,27(2):116-118. [6] 任书瑶,张博静,韩国宏. 门静脉高压BavenoⅥ共识:门静脉高压的危险分层及个体化治疗[J]. 中华消化杂志,2015,35(8):505-509. [7] de Franchis R,Pascal JP,Ancona E,et al. Definitions, methodology and therapeutic strategies in portal hypertension. A consensus development workshop[J]. J Hepatol, 1992, 15(1-2):256-261. [8] de Franchis R. Developing consensus in portal hypertension[J]. J Hepatol,1996,25(1-2):390-394. [9] de Franchis R. Updating consensus in portal hypertension: report of the Baveno III consensus workshop on definitions, methodology and therapeutic strategies in portal hypertension[J]. J Hepatol,2000,33(5):846-852. [10] de Franchis R. Evolving consensus in portal hypertension. Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension[J]. J Hepatol,2005,43(1):167-176. [11] de Franchis R,Baveno V Faculty. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension[J]. J Hepatol,2010,53(4):762-768. [12] de Franchis R, Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI consensus workshop: stratifying risk and individualizing care for portal hypertension[J]. J Hepatol,2015,63(3):743-752. [13] 彭颖,祁兴顺,郭晓钟. 2015年Baveno Ⅵ共识:门静脉高压的风险分层及个体化管理[J]. 临床肝胆病杂志,2015,31(8):1202-1207. [14] 张春清,李晶. 从BavenoⅥ共识看肝硬化食管胃底静脉曲张的个体化治疗[J].临床肝胆病杂志,2016,32(2):242-244. [15] 马婉蓉,范国鑫. 肝静脉压力梯度研究进展[J]. 中华实用诊断与治疗杂志, 2013, 27(9):835-836. [16] 中国门静脉高压诊断与监测研究组(CHESS),中华医学会消化病学分会微创介入协作组,中国医师协会介入医师分会急诊介入专业委员会,等. 中国肝静脉压力梯度临床应用专家共识(2018版)[J].临床肝胆病杂志,2018,34 (12) : 2526-2536. [17] 何福亮,欧晓娟,王民,等. 肝静脉压力梯度对肝硬化临床终点事件的预测[J].临床肝胆病杂志,2020,36 (9):1931-1935. [18] Trebicka J, Gu W, Ibánez-Samaniego L, et al. Rebleeding and mortality risk are increased by ACLF but reduced by pre-emptive TIPS[J]. J Hepatol, 2020, 73(5):1082-1091. [19] 刘林祥,聂源,朱萱. 瞬时弹性成像技术在肝硬化及其并发症中的应用[J]. 临床肝胆病杂志,2020,36(6):1362-1365. [20] 宋凯敏,刘俊. 瞬时弹性成像技术在慢性乙型肝炎中的应用进展[J]. 临床肝胆病杂志,2021,37(2):419-424. [21] 刘丹, 段庆红. 剪切波弹性成像与瞬时弹性成像技术诊断肝硬化食管胃底静脉曲张程度的对比研究[J]. 临床超声医学杂志, 2021, 23(6):437-440. [22] Vizzutti F, Arena U, Romanelli R, et al.Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis[J]. Hepatology, 2007, 45(5):1290-1297. [23] Cassinotto C,Charrie A,Mouries A,et al. Liver and spleen elastography using supersonic shear imaging for the non-invasive diagnosis of cirrhosis severity and oesophageal varices[J]. Dig Liver Dis, 2015, 47(8):695-701. [24] 林欣,尚国臣,齐翠花,等. 利用瞬时弹性成像技术对肝脏、脾脏硬度的测定及其与肝硬化食管静脉曲张程度的关系[J]. 中华消化杂志,2018,38(2):129-131. [25] 杨学平. 瞬时弹性成像检测肝脾硬度预测食管静脉曲张的价值[J]. 中国超声医学杂志,2017,33(2):139-142. [26] Manatsathit W,Samant H,Kapur S,et al. Accuracy of liver stiffness, spleen stiffness, and LS-spleen diameter to platelet ratio score in detection of esophageal varices: systemic review and meta-analysis[J]. J Gastroenterol Hepatol, 2018, 33(10):1696-1706. [27] Calvaruso V, Cacciola I, Licata A, et al. Is transient elastography needed for noninvasive assessment of high-risk varices? The REAL experience[J]. Am J Gastroenterol,2019,114(8):1275-1282. [28] 袁平戈. 瞬时弹性成像技术在肝病诊断中的应用进展[J]. 实用肝脏病杂志, 2016, 19(1):4-7. [29] Alvarez MA, Cirera I, Solà R, et al. Long-term clinical course of decompensated alcoholic cirrhosis: a prospective study of 165 patients[J]. J Clin Gastroenterol, 2011, 45 (10):906-911. [30] Pu K,Shi JH,Wang X,et al. Diagnostic accuracy of transient elastography (FibroScan) in detection of esophageal varices in patients with cirrhosis: a meta-analysis[J]. World J Gastroenterol,2017,23(2):345-356. [31] van Katwyk S, Coyle D, Cooper C, et al. Transient elastography for the diagnosis of liver fibrosis: a systematic review of economic evaluations[J]. Liver Int, 2017, 37(6):851-861. [32] Augustin S, Pons M, Maurice JB, et al. Expanding the Baveno VI criteria for the screening of varices in patients with compensated advanced chronic liver disease[J]. Hepatology,2017,66(6):1980-1988. [33] Samanta T, Biswas K, Ghosh S, et al. Validation of revised Baveno VI criteria for screening of varices needing treatment in children with cirrhosis[J]. Clin Exp Gastroenterol, 2020, 13: 503-509. [34] Zheng KI, Liu C, Li J, et al. Validation of Baveno VI and expanded Baveno VI criteria to identify high-risk varices in patients with MAFLD-related compensated cirrhosis[J]. J Hepatol, 2020, 73(6):1571-1573. [35] Stafylidou M, Paschos P, Katsoula A, et al. Performance of Baveno VI and expanded Baveno VI criteria for excluding high-risk varices in patients with chronic liver diseases: a systematic review and metaanalysis[J].Clin Gastroenterol Hepatol, 2019, 17(9):1744-1755. [36] Gaete MI, Díaz LA, Arenas A, et al. Baveno VI and expanded Baveno VI criteria successfully predicts the absence of high-risk gastro-oesophageal varices in a Chilean cohort[J]. Liver Int, 2020, 40(6):1427-1434. [37] Chang PE, Tan CK, Cheah CC, et al. Validation of the expanded Baveno-VI criteria for screening gastroscopy in Asian patients with compensated advanced chronic liver disease[J]. Dig Dis Sci, 2021, 66(4):1343-1348. [38] Colecchia A, Ravaioli F, Marasco G, et al.A combined model based on spleen stiffness measurement and Baveno VI criteria to rule out high-risk varices in advanced chronic liver disease[J]. J Hepatol, 2018, 69(2):308-317. [39] Wong GL, Liang LY, Kwok R, et al. Low risk of variceal bleeding in patients with cirrhosis after variceal screening stratified by liver/spleen stiffness[J]. Hepatology, 2019, 70(3):971-981. [40] Wang HY, Wen B, Chang XY, et al.Baveno VI criteria and spleen stiffness measurement rule outhigh-risk varices in virally suppressed HBV-related cirrhosis[J]. J Hepatol, 2021, 74(3):584-592. [41] Colley DG, Bustinduy AL, Secor WE, et al. Human schistosomiasis[J]. Lancet, 2014, 383(9936):2253-2264. [42] Klohe K,Koudou BG,Fenwick A,et al.A systematic literature review of schistosomiasis in urban and peri-urban settings[J].PLoS Negl Trop Dis, 2021, 15(2):e0008995. [43] Zhou YB, Chen Y, Jiang QW. History of human schistosomiasis (bilharziasis) in China: from discovery to elimination[J]. Acta Parasitol, 2021, 66(3):760-769. [44] 神学慧,王琳,李叶芳,等.镇江市丹徒区羊血吸虫病疫情监测结果分析[J].实用预防医学, 2020,27(9):1047-1051. [45] 张利娟,徐志敏,杨帆,等. 2020年全国血吸虫病疫情通报[J]. 中国血吸虫病防治杂志,2021,33(3):225-233. [46] 许静,胡薇,杨坤,等. “十四五”期间我国血吸虫病防治重点及研究方向[J]. 中国血吸虫病防治杂志,2021,33(1):1-6. [47] 刘蓉,闻礼永. 晚期血吸虫病基础和临床研究新进展[J]. 中国寄生虫学与寄生虫病杂志,2021,39(4):429-435. [48] Wu W,Feng A,Huang Y.Research and control of advanced schistosomiasis japonica in China[J].Parasitol Res, 2015, 114(1):17-27. [49] 李爽,张德发,陆伟,等. 内镜超声检查术对食管静脉曲张出血风险的预测价值[J]. 中华消化内镜杂志,2017,34(12):887-891. [50] 祁小龙. 肝癌门静脉高压症诊断与监测新技术(上)[J/CD]. 中华实验和临床感染病杂志 (电子版), 2021, 15(1):72. [51] 祁小龙. 肝癌门静脉高压症诊断与监测新技术(下)[J/CD]. 中华实验和临床感染病杂志 (电子版), 2021, 15(2):144.