摘要
目的探讨肝硬化食管静脉曲张非创伤性临床指标与出血的相关性。拟建立一个预测是否出血的非创伤性多因素评分系统。方法回顾性分析290例肝硬化住院患者的临床资料。先以单因素非条件Logistic回归分析筛选出有统计学意义的危险因素，再应用多因素非条件Logistic回归分析筛选出能预测肝硬化食管静脉曲张破裂出血的非创伤性独立危险因素。通过Logistic回归分析建立一个预测肝硬化食管静脉曲张破裂出血的多因素评分系统。结果单因素非条件Logistic回归分析结果表明：肝硬化病程、诱因、病前感染、食管静脉曲张程度、红色征、脾脏厚度、脾静脉宽度、门静脉宽度、门静脉血流速度、腹水、血小板计数、尿素氮、总胆固醇、凝血酶原时间与出血相关。多因素非条件Logistic回归分析结果表明：脾脏厚度、门静脉宽度、腹水、血小板计数、白蛋白、凝血酶原时间是食管静脉曲张破裂出血的非创伤性预测危险因素。以该6项指标建立评分系统。总分157．717分为判断患者出血的临界值。结论肝硬化食管静脉曲张破裂出血的非创伤性预测因素是脾脏厚度、门静脉宽度、腹水、血小板计数、白蛋白、凝血酶原时间。
Objective To evaluate the correlation between noninvasive clinical indexes and variceal hemorrhage in patients with liver cirrhosis,and make a noninvasive score system to prognosticate if esophageal varieeal hemorrhage or not. Methods Retrospectively analyzed the clinical materials of 290 cirrhotic inpatients. First, these materials were analyzed by simple factor Logistic regression analysis and＂ the signifieative factors were chosen. Second, these materials were analyzed by multi-factors Logistic regression analysis and the noninvasive risk factors were chosen for esophageal varieeal hemorrhage in patients with liver cirrhosis. Then made a noninvasive score system to prognosticate if esophageal variceal hemorrhaged or not. Results Simple Logistic regression analysis showed that there was a positive correlation between hemor- rhage and course of diseases,infections,esophageal varix level,aseites sign, spleen thickness, spleen vein diameter, portal vein diameter, portal vein blood velocity, platelet count, blood urea nitrogen, total cholesterol and prothrombin time. Multi-factors Logistic regression analysis revealed that noninvasive independent risk factors of esophageal varieeal hemorrhage in liver cirrhosis were spleen thickness,portal vein diameter,as- cites sign, platelet count, albumin and prothrombin time. A score system was made according to those pa- rameters. Cut offliminal score was 157.717 scores. Conclusions The noninvasive independent risk factors of cirrhosis with esophageal varieeal hemorrhage are spleen thickness,portal vein diameter,aseites sign, platelet count, albumin and prothrombin time. Esophageal varieeal hemorrhage can be predicted by this score system.
出处
《中国医师进修杂志（内科版）》
2007年第12期13-15,21,共4页
Chinese Journal of Postgraduates of Medicine
