目的探讨AIMS65评分在肝硬化食管胃底静脉曲张破裂出血(esophageal and gastric variceal bleeding,EGVB)患者住院死亡中的预测价值。方法回顾性纳入我院2016年1月至2020年12月诊治的378例肝硬化EGVB患者,根据住院期间生存情况分为存活...目的探讨AIMS65评分在肝硬化食管胃底静脉曲张破裂出血(esophageal and gastric variceal bleeding,EGVB)患者住院死亡中的预测价值。方法回顾性纳入我院2016年1月至2020年12月诊治的378例肝硬化EGVB患者,根据住院期间生存情况分为存活组345例(91.27%)和死亡组33例(8.73%)。通过电子病历系统收集患者入院时临床资料,采用多因素Logistic回归分析EGVB患者住院期间死亡的危险因素。采用ROC曲线分析AIMS65评分预测EGVB患者住院期间死亡的效能。结果单因素分析显示,死亡组中重度腹水、有肝性脑病的比例以及GBS评分、FRS评分、AIMS65评分均高于存活组(P<0.05),年龄、性别、高血压等与存活组比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,GBS评分(OR=1.704,95%CI:1.069~2.717,P=0.026)、FRS评分(OR=1.758,95%CI:1.160~2.663,P=0.008)、AIMS65评分(OR=1.868,95%CI:1.228~2.842,P=0.002)是肝硬化EGVB患者住院期间死亡的危险因素。ROC曲线分析显示,AIMS65评分预测EGVB患者住院期间死亡的AUC为0.836(95%CI:0.781~0.891),敏感性为72.73%,特异性为82.03%。结论AIMS65评分升高是肝硬化EGVB患者住院期间死亡的危险因素,可预测该类人群短期死亡风险。展开更多
<strong>Objective</strong><span><span><span style="font-family:;" "=""><strong>:</strong> To evaluate and compare the prognostic contribution of diffe...<strong>Objective</strong><span><span><span style="font-family:;" "=""><strong>:</strong> To evaluate and compare the prognostic contribution of different UGIB prognostic scores. <b>Patients and Method</b>: Descriptive cross-sectional study with retrospective collection conducted from January 2014 to December 2019. Patients hospitalized in the Gastroenterology Department of Campus Teaching Hospital of Lome for upper gastrointestinal hemorrhage were included. The analytical component of this study had consisted of an evaluation of the sensitivity and specificity of different prognostic scores (GBS, mGBS, FRS, CRS, AIMS65) in predicting the occurrence of death and/or re-bleeding within 42 days. These different scores were compared using ROC (Receiver Operating Characteristic) curves. <b>Results</b>: We included 314 patients in our study. The male to female sex ratio was 2.48. Fibroscopy found non-related portal hypertension UGIB in 70.94% of the cases. The “FRS” was the most accurate score in predicting death or re-bleeding in all patients. The “FRS” was the most precise score in predicting the occurrence of spotting in all patients. The “FRS” was the most accurate score in predicting death among all patients. The mortality of patients at low risk of death (below the threshold value) was 2.2% for the “FRS”, 9.3% for the “CRS”, 0% for the “GBS” (p = 0.565), 50% for the “mGBS” and 11.4% for the “AIMS65”. Scores were more accurate for non-related portal hypertension UGIB. <b>Conclusion</b>: The “FRS” and the “CRS” are two precise scores in predicting the occurrence of an incident in the event of upper gastrointestinal hemorrhage. However, these scores were less effective in related portal hypertension UGIB</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span>展开更多
背景急性非静脉曲张性上消化道出血后存在再出血风险,且再出血会增加不良预后风险,但现阶段尚缺乏有效的预测手段.红细胞分布宽度、血红蛋白、胃泌素水平变化均与出血类疾病有关,推测可为临床完善相关机制、预测出血发生提供参考.目的...背景急性非静脉曲张性上消化道出血后存在再出血风险,且再出血会增加不良预后风险,但现阶段尚缺乏有效的预测手段.红细胞分布宽度、血红蛋白、胃泌素水平变化均与出血类疾病有关,推测可为临床完善相关机制、预测出血发生提供参考.目的探讨红细胞分布宽度(red cell distribution width,RDW)、血红蛋白(hemoglobin,Hb)、胃泌素(gastrin,GAS)与急性非静脉曲张性上消化道出血(acute nonvariceal upper gastrointestinal bleeding,ANVUGIB)患者Glasgow-Blatchford评分(Glasgow-Blatchford score,GBS)、AIMS65评分的关系及预测再出血的价值.方法选取2018-08/2021-02我院收治的122例ANVUGIB患者进行回顾性研究,根据发病后7 d是否发生再出血分为再出血组(n=31)、无再出血组(n=91),比较两组基线资料、RDW、Hb、GAS、GBS评分、AIMS65评分,采用Pearson分析各指标与GBS、AIMS65评分关系,采用多因素Logistic回归方程分析再出血的相关影响因素,采用受试者工作特征曲线(receiver operating characteristic,ROC)及ROC下面积(area under the curve,AUC)分析各指标预测再出血的价值,并比较各指标不同表达水平者再出血发生率.结果再出血组既往消化道出血患者占比高于无再出血组,RDW、GAS、GBS、AIMS65评分高于无再出血组,Hb低于无再出血组(P<0.05);RDW、GAS与GBS、AIMS65评分呈正相关,Hb与GBS、AIMS65评分呈负相关(P<0.05);多因素Logistic回归方程分析显示,将既往消化道出血、GBS、AIMS65评分控制后,RDW、Hb、GAS仍是再出血的相关影响因素(P<0.05);RDW、Hb联合GAS预测再出血的AUC(0.850)大于RDW(0.721)、Hb(0.721)、GAS(0.806);RDW、GAS高水平者再出血率高于低水平者,Hb高水平者再出血率低于低水平者(P<0.05).结论RDW、Hb、GAS与ANVUGIB患者病情危险度和再出血风险有关,联合检测可作为评估病情危险度及预测再出血的一个可靠方案,为临床治疗提供参考信息.展开更多
文摘目的探讨AIMS65评分在肝硬化食管胃底静脉曲张破裂出血(esophageal and gastric variceal bleeding,EGVB)患者住院死亡中的预测价值。方法回顾性纳入我院2016年1月至2020年12月诊治的378例肝硬化EGVB患者,根据住院期间生存情况分为存活组345例(91.27%)和死亡组33例(8.73%)。通过电子病历系统收集患者入院时临床资料,采用多因素Logistic回归分析EGVB患者住院期间死亡的危险因素。采用ROC曲线分析AIMS65评分预测EGVB患者住院期间死亡的效能。结果单因素分析显示,死亡组中重度腹水、有肝性脑病的比例以及GBS评分、FRS评分、AIMS65评分均高于存活组(P<0.05),年龄、性别、高血压等与存活组比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,GBS评分(OR=1.704,95%CI:1.069~2.717,P=0.026)、FRS评分(OR=1.758,95%CI:1.160~2.663,P=0.008)、AIMS65评分(OR=1.868,95%CI:1.228~2.842,P=0.002)是肝硬化EGVB患者住院期间死亡的危险因素。ROC曲线分析显示,AIMS65评分预测EGVB患者住院期间死亡的AUC为0.836(95%CI:0.781~0.891),敏感性为72.73%,特异性为82.03%。结论AIMS65评分升高是肝硬化EGVB患者住院期间死亡的危险因素,可预测该类人群短期死亡风险。
文摘<strong>Objective</strong><span><span><span style="font-family:;" "=""><strong>:</strong> To evaluate and compare the prognostic contribution of different UGIB prognostic scores. <b>Patients and Method</b>: Descriptive cross-sectional study with retrospective collection conducted from January 2014 to December 2019. Patients hospitalized in the Gastroenterology Department of Campus Teaching Hospital of Lome for upper gastrointestinal hemorrhage were included. The analytical component of this study had consisted of an evaluation of the sensitivity and specificity of different prognostic scores (GBS, mGBS, FRS, CRS, AIMS65) in predicting the occurrence of death and/or re-bleeding within 42 days. These different scores were compared using ROC (Receiver Operating Characteristic) curves. <b>Results</b>: We included 314 patients in our study. The male to female sex ratio was 2.48. Fibroscopy found non-related portal hypertension UGIB in 70.94% of the cases. The “FRS” was the most accurate score in predicting death or re-bleeding in all patients. The “FRS” was the most precise score in predicting the occurrence of spotting in all patients. The “FRS” was the most accurate score in predicting death among all patients. The mortality of patients at low risk of death (below the threshold value) was 2.2% for the “FRS”, 9.3% for the “CRS”, 0% for the “GBS” (p = 0.565), 50% for the “mGBS” and 11.4% for the “AIMS65”. Scores were more accurate for non-related portal hypertension UGIB. <b>Conclusion</b>: The “FRS” and the “CRS” are two precise scores in predicting the occurrence of an incident in the event of upper gastrointestinal hemorrhage. However, these scores were less effective in related portal hypertension UGIB</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span>
文摘背景急性非静脉曲张性上消化道出血后存在再出血风险,且再出血会增加不良预后风险,但现阶段尚缺乏有效的预测手段.红细胞分布宽度、血红蛋白、胃泌素水平变化均与出血类疾病有关,推测可为临床完善相关机制、预测出血发生提供参考.目的探讨红细胞分布宽度(red cell distribution width,RDW)、血红蛋白(hemoglobin,Hb)、胃泌素(gastrin,GAS)与急性非静脉曲张性上消化道出血(acute nonvariceal upper gastrointestinal bleeding,ANVUGIB)患者Glasgow-Blatchford评分(Glasgow-Blatchford score,GBS)、AIMS65评分的关系及预测再出血的价值.方法选取2018-08/2021-02我院收治的122例ANVUGIB患者进行回顾性研究,根据发病后7 d是否发生再出血分为再出血组(n=31)、无再出血组(n=91),比较两组基线资料、RDW、Hb、GAS、GBS评分、AIMS65评分,采用Pearson分析各指标与GBS、AIMS65评分关系,采用多因素Logistic回归方程分析再出血的相关影响因素,采用受试者工作特征曲线(receiver operating characteristic,ROC)及ROC下面积(area under the curve,AUC)分析各指标预测再出血的价值,并比较各指标不同表达水平者再出血发生率.结果再出血组既往消化道出血患者占比高于无再出血组,RDW、GAS、GBS、AIMS65评分高于无再出血组,Hb低于无再出血组(P<0.05);RDW、GAS与GBS、AIMS65评分呈正相关,Hb与GBS、AIMS65评分呈负相关(P<0.05);多因素Logistic回归方程分析显示,将既往消化道出血、GBS、AIMS65评分控制后,RDW、Hb、GAS仍是再出血的相关影响因素(P<0.05);RDW、Hb联合GAS预测再出血的AUC(0.850)大于RDW(0.721)、Hb(0.721)、GAS(0.806);RDW、GAS高水平者再出血率高于低水平者,Hb高水平者再出血率低于低水平者(P<0.05).结论RDW、Hb、GAS与ANVUGIB患者病情危险度和再出血风险有关,联合检测可作为评估病情危险度及预测再出血的一个可靠方案,为临床治疗提供参考信息.
