摘要
目的:分析Glasgow-Blatchford评分(GBS)应用于肝硬化食管胃底静脉曲张破裂出血患者治疗的预后预测。方法:选取2020年9月—2023年9月于赣州市第五人民医院接受治疗的126例肝硬化食管胃底静脉曲张破裂出血患者,按照研究对象在院期间预后情况的不同分为死亡组(n=17)和存活组(n=109)。对比存活组和死亡组的临床资料、血常规情况及GBS;对上述存在差异的指标进行logistic回归分析;使用ROC曲线评价GBS对患者死亡的预测价值。结果:两组吸烟史比较,差异无统计学意义(P>0.05),死亡组年龄大于存活组,死亡组饮酒史比例、血小板计数(PLT)、白细胞(WBC)计数、中性粒细胞(NEU)计数、GBS均高于存活组,血红蛋白(Hb)低于存活组,差异均有统计学意义(P<0.05)。logistic回归分析可见年龄较大、存在饮酒史、Hb降低、PLT升高、WBC升高、NEU升高、GBS升高为肝硬化食管胃底静脉曲张破裂出血患者死亡的独立危险因素(P<0.05)。经ROC曲线分析后可见GBS预测死亡的敏感度为83.30%,特异度为89.20%,AUC为0.842。结论:GBS升高为肝硬化食管胃底静脉曲张破裂出血患者死亡的独立危险因素,其对患者治疗后不良预后具有良好的预测价值。
Objective:To analyze the prognostic value of Glasgow-Blatchford score(GBS)in patients with esophageal and gastric varices bleeding caused by cirrhosis.Method:A total of 126 patients with esophageal and gastric varices bleeding caused by cirrhosis who were treated in Ganzhou Fifth People's Hospital from September 2020 to September 2023 were selected,and the study subjects were divided into the death group(n=17)and the survival group(n=109)according to the difference of their prognosis during the period of hospital stay.The clinical data,blood routine and GBS of the survivor group and the death group were compared;logistic regression analyses was performed to analyze the above mentioned indexes;and ROC curve was used to analyze the predictive value of GBS for death of patients.Result:There was no significant difference in smoking history between two groups(P>0.05).The death group was older than the survival group.The proportion of drinking history,platelet(PLT)count,white blood cell(WBC)count,neutrophil(NEU)count and GBS in the death group were higher than those in the survival group,and hemoglobin(Hb)was lower than that in the survival group,the differences were statistically significant(P<0.05).logistic regression analysis showed that older age,drinking history,decreased Hb,increased PLT,increased WBC,increased NEU,and increased GBS were independent risk factors for death in patients with esophageal and gastric varices bleeding caused by cirrhosis(P<0.05).ROC curve analysis showed that the sensitivity of GBS for predicting death was 83.30%,the specificity was 89.20%,and the AUC was 0.842.Conclusion:Elevated GBS is an independent risk factor for death in patients with esophageal and gastric varices bleeding caused by cirrhosis,and it has good predictive value for poor prognosis after treatment.
作者
黄富烽
HUANG Fufeng(Department of Hepatology,Ganzhou Fifth People's Hospital(Ganzhou Institute of Liver Diseases),Ganzhou 341000,China)
出处
《中国医学创新》
CAS
2024年第28期137-140,共4页
Medical Innovation of China
基金
赣州市卫生健康委员会市级科研计划项目(2023-2-064)。
