摘要
目的 探讨完整和临床Rockall评分对老年急性非静脉曲张上消化道出血患者输血、再出血、干预和死亡的预测价值.方法 采用完整和临床Rockau评分系统对老年急性非静脉曲张上消化道出血患者进行危险程度分级,并与同期非老年组比较,应用ROC曲线评估两个评分系统的预测价值.结果 随着评分增加,老年临床高危患者所占比例逐渐增加,两者呈正相关（P＜0.05）.完整Rockall评分对老年患者输血、再出血、干预和死亡均有较好的预测价值,受试者工作特征曲线下面积AUC值分别为0.67、0.84、0.70和0.96（P ＜0.01）;临床Rockall评分对老年患者输血、再出血和死亡有较好的预测价值,AUC值分别为0.66、0.79和0.91（P ＜0.01）,对干预无预测价值（P＞0.05）.结论 老年急性非静脉曲张上消化道出血患者可用较为简单的临床Rockall评分预测输血、再出血和死亡风险.
Objective To investigate the predictive values of full and clinical Rockall score in the transfusion, rebleeding, intervention and death of the elderly patients with acute nonvariceal upper gas- trointestinal bleeding. Methods The full and clinical Rockall score system were used to grade the risks in elderly and non-elderly patients with acute nonvariceal upper gastrointestinal bleeding. The receiver op- erating characteristic （ROC） curve was used to evaluate the predictive value of both score systems. Re- suits With the increase of full or clinical Rockall score, the proportion of patients with high clinical risk increased significantly, the correlation between them was positive （ P 〈 0.05 ）. The area under the ROC curve （AUC） of full Rockall scores for the assessment of transfusion, rebleeding, intervention and death in the elderly patients with acute nonvariceal upper gastrointestinal bleeding were 0.67 （P 〈 0.01 ） ,0.84 （P 〈0.01 ） ,0.70（P 〈0.01 ） ,0.96（P 〈0.01 ） ,respectively. The AUC of clinical Rockall scores for the as- sessment of transfusion,rebleeding and death were 0.66 （ P 〈 0. 01 ） ,0. 79 （ P 〈 0.01 ） and 0.91 （ P 〈 0.01 ）, respectively ,whereas there was no predictive value for the assessment of intervention. Conclusions Clinical Rockall score system could be used to predict the risks of transfusion, intervention and death in elderly patients with acute nonvariceal upper gastrointestinal bleeding.
出处
《临床内科杂志》
CAS
2014年第11期737-740,共4页
Journal of Clinical Internal Medicine
