首页|OASIS评分联合血小板-白蛋白-胆红素指数与急性上消化道出血病情的相关性及对预后评估价值

OASIS评分联合血小板-白蛋白-胆红素指数与急性上消化道出血病情的相关性及对预后评估价值

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目的:探究牛津急性疾病严重程度(OASIS)评分联合血小板-白蛋白-胆红素(PALBI)指数与急性上消化道出血(AUGB)患者病情的相关性及对预后的评估价值。方法:回顾性分析我院 165例AUGB患者资料,根据《急性上消化道出血急诊诊治流程专家共识 2020》危险分级将患者分为高危组(n=44)、中危组(n=63)和低危组(n=58),比较三组入院OASIS 评分和PALBI指数,采用Spearman 相关分析OASIS评分和PALBI指数与AUGB疾病危险程度的关系,所有患者均进行临床治疗,根据治疗后是否发生再出血、重症监护、死亡将患者分为预后良好组(n=114)和预后不良组(n=51),比较两组一般临床资料和实验室指标,采用Logistic回归模型分析影响AUGB 患者预后的相关因素,采用受试者工作特征(ROC)曲线分析OASIS评分和PALBI指数对AUGB患者预后的评估价值。结果:高危组OA-SIS评分、PALBI指数均显著高于中危组、低危组(P<0。05),中危组 OASIS 评分、PALBI 指数均显著高于低危组(P<0。05);Spearman相关分析显示,OASIS评分和 PALBI 指数与 AUGB 疾病危险程度均呈正相关(P<0。05);预后不良组AUGB次数、呕血、幽门螺杆菌感染占比、心率、呼吸频率、OASIS评分、PAL-BI指数值高于预后良好组(P<0。05),HBG、ALB、PLT值低于预后良好组(P<0。05),两组性别、年龄、BMI、既往史、晕厥、黑便、心力衰竭占比、病因、血清 TBIL、ALT、AST、Ser、UA、BUN 水平、PT、TT、APTT值比较,差异无统计学意义(P>0。05);多因素 Logistic 回归分析显示,AUGB 次数、呕血、OASIS 评分、PALBI指数是影响AUGB患者预后的危险因素(P<0。05);ROC曲线分析显示,OASIS评分、PALBI指数单独及联合预测 AUGB 患者预后的敏感度为 88。24%、70。59%、90。20%,特异度为 80。70%、78。95%、84。21%,AUC为0。897、0。806、0。929,联合诊断预测价值更高。结论:OASIS 评分、PALBI指数与AUGB患者病情相关,且对患者预后具有较高的预测价值。
Correlation of OASIS Score Combined with Platelet-Albumin-Bilirubin Index with the Severity of Acute Upper Gastrointestinal Bleeding and Its Value in Prognostic Assessment
Objective:To investigate the correlation of oxford acute severity of illness score(OASIS)combined with platelet-albumin-bilirubin index(PALBI)with the severity of acute upper gastrointestinal bleeding(AUGB)and its evaluated value on prognosis.Methods:The data of 165 patients with AUGB in our hospital were retrospectively analyzed,and the patients were divided into high-risk group(n=44),medium-risk group(n=63)and low-risk group(n=58)according to the risk classification of Expert Consensus 2020 on the Emergency Diagnosis and Treatment of Acute Upper Gastrointestinal Bleeding.OASIS score and PALBI index were compared among the three groups.Spearman correlation analysis was used to analyze the relation-ship between OASIS score and PALBI index and risk degree of AUGB.All patients underwent clinical treat-ment,and then they were divided into good prognosis group(n=114)and poor prognosis group(n=51)ac-cording to whether rebleeding,intensive care and death occurred after treatment.The general clinical data and laboratory indicators were compared between the two groups,Logistic regression model was applied to analyze the related factors affecting the prognosis of patients with AUGB,and receiver operating characteristics(ROC)curve was used to analyze the value of OASIS score and PALBI index on the prognosis of patients with AUGB.Results:OASIS score and PALBI index in high-risk group were significantly higher than those in middle-risk group and low-risk group(P<0.05),and OASIS score and PALBI index in middle-risk group were signifi-cantly higher than those in low-risk group(P<0.05).Spearman correlation analysis analysis showed that OA-SIS score and PALBI index were significantly positively correlated with AUGB risk degree(P<0.05).AUGB frequency,proportions of hematemesis and Helicobacter pylori infection,heart rate,respiratory rate,OASIS score and PALBI index in poor prognosis group were significantly higher than those in good prognosis group(P<0.05)while HBG,ALB and PLT were significantly lower than those in good prognosis group(P<0.05).There were no statistically significant differences in gender,age,BMI,past history,proportions of syncope,melena and heart failure,etiology,serum TBIL,ALT,AST,Ser,UA,BUN,PT,TT and APTT between the two groups(P>0.05).Multivariate Logistic regression analysis showed that AUGB frequency,hematemesis,OASIS score and PALBI index were the risk factors affecting the prognosis of patients with AUGB(P<0.05).ROC curve analysis showed that the sensitivities of OASIS score and PALBI index alone and in combination in predicting prognosis of patients with AUGB were 88.24%,70.59%and 90.20%,and the specificities were 80.70%,78.95%and 84.21%,and the AUCs were 0.897,0.806 and 0.929 respectively.Combined diag-nosis had higher predictive value.Conclusion:OASIS score and PALBI index are significantly correlated with disease condition of patients with AUGB,and have high predictive value on prognosis of patients.

Acute upper gastrointestinal bleedingOxford acute severity of illness scorePlatelet-albumin-bilirubin indexPrognosis

常琳琳、代子艳、周亚柏、王桂周、陆启峰、王双平

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安徽省阜阳市人民医院消化内科, 安徽 阜阳 236000

急性上消化道出血 牛津急性疾病严重程度评分 血小板-白蛋白-胆红素指数 预后

安徽省中医药传承创新科研项目(2022)

2022CCZC31

2024

河北医学
河北省医学会

河北医学

CSTPCD
影响因子:1.915
ISSN:1006-6233
年,卷(期):2024.30(3)
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