摘要
目的:探讨分析血清ALB、LN在肝硬化上消化道出血临床诊断中的应用意义。方法:选取2019年1-12月本院收治的肝硬化合并消化道出血的60例患者作为研究组;选取同期本院收治的单纯肝硬化的60例患者作为对照组。比较两组一般资料指标,分析发生消化道出血的相关因素,计算界限值下的血清ALB及血清LN诊断消化道出血的特异度及灵敏度,研究组治疗前后的血清ALB及血清LN水平变化情况。结果:研究组既往消化道出血史、食管静脉曲张、腹水及门脉高压性胃病、ALB≤20 g/L、LN>175 μg/L占比均高于对照组(P<0.05),研究组Child-Pugh分级情况与对照组比较,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,影响发生消化道出血的相关因素为血清ALB、血清LN、腹水及食管静脉曲张(P<0.05)。将ALB<28 g/L作为诊断消化道出血的判定值,研究组诊断灵敏度91.7%(55/60),对照组特异度70.0%(42/60)。将LN>200 μg/L作为诊断消化道出血的判定值,研究组诊断灵敏度75.0%(45/60),对照组特异度66.7%(40/60)。治疗后,研究组血清ALB水平高于治疗前,血清LN水平低于治疗前,差异均有统计学意义(P<0.05)。结论:联合检测血清ALB水平及血清LN水平,可有效地给予肝硬化消化道出血患者进行临床诊断及评估。
Objective:To explore the significance of serum ALB and LN in the clinical diagnosis of upper gastrointestinal hemorrhage in cirrhosis.Method:A total of 60 patients with liver cirrhosis complicated with gastrointestinal bleeding admitted to our hospital from January to December 2019 were selected as the study group,60 patients with simple cirrhosis admitted to our hospital during the same period were selected as the control group.The general data indexes of the two groups were compared to analyze the related risk factors for gastrointestinal bleeding.The specificity and sensitivity of serum ALB and serum LN in the diagnosis of gastrointestinal bleeding were calculated under the threshold value.The changes of serum ALB and serum LN levels before and after treatment in the study group were also calculated.Result:The previous history of gastrointestinal bleeding,esophageal varices,ascites and portal hypertensive gastropathy,ALB≤20 g/L,and LN>175 μg/L in the study group were higher than those in the control group (P<0.05),there were statistically significant differences between the Chil-Pugh grades of the control group (P<0.05).Logistic regression analysis showed that serum ALB,serum LN,ascites and esophageal varicose veins were the related risk factors for gastrointestinal bleeding (P<0.05).When ALB<28 g/L was used as the diagnostic value for gastrointestinal bleeding,the sensitivity was 91.7% (55/60) in the study group and the specificity was 70.0% (42/60) in the control group.The sensitivity was 75.0% (45/60) in the study group and the specificity was 66.7% (40/60) in the control group.After treatment,the serum ALB level of the study group was higher than before treatment,the serum LN level was lower than before treatment,the differences were statistical significance (P<0.05).Conclusion:The combined detection of ALB and LN can effectively diagnose and evaluate the patients with gastrointestinal hemorrhage due to liver cirrhosis.
作者
梁丹红
何嘉敏
黄换桂
LIANG Danhong;HE Jiamin;HUANG Huangui(Dongguan Hospital of Medicine,Dongguan 523000,China;不详)
出处
《中国医学创新》
CAS
2021年第5期45-48,共4页
Medical Innovation of China
关键词
肝硬化
消化道出血
血清ALB
血清LN
Liver cirrhosis
Gastrointestinal hemorrhage
Serum ALB
Serum LN
