尿素氮/肌酐比值在急性上消化道出血中的诊断价值:一项基于倾向性得分匹配分析(PSM)的研究
The Diagnostic Value of Urea Nitrogen to Creatinine Ratio in Acute Upper Gastrointestinal Bleeding Patients:A Propensity Score Matching Study
黎童 1梁炼 1杨正飞 1汤永峰 1黄招娣 1李祖勇1
作者信息
- 1. 中山大学孙逸仙纪念医院急诊科(510120)
- 折叠
摘要
目的:探讨尿素氮/肌酐比值(BUN/Cr)在急性上消化道出血中的诊断价值.方法:本回顾性病例对照研究纳入被诊断为急性上消化道出血的患者作为病例组,并选择同期非上消化道出血的患者作为对照组.使用倾向得匹配分析(PSM)来平衡两组患者.多因素Logistic回归分析以确定上消化道出血的独立风险因素,并进行受试者工作特征曲线(ROC)分析来评估BUN/Cr在诊断急性上消化道出血中的准确性,计算曲线下面积(AUC).结果:病例组的BUN/Cr显著高于对照组[PSM前(104.80±34.37)vs(57.60±17.20),P<0.05];PSM后[(105.12±33.73)vs(58.15±17.9),P<0.05].多因素Logistic回归分析显示,BUN/Cr比值、年龄和男性是上消化道出血的独立风险因素.在诊断上消化道出血的ROC分析中,未进行PSM匹配时的AUC为0.924,进行PSM匹配后为0.914.高BUN/Cr比值是不同性别、年龄、肾功能不全和肝硬化亚组中上消化道出血的独立风险因素.结论:BUN/Cr在急性上消化道出血的诊断能力优异.
Abstract
Objective:To investigate the diagnostic value of the blood urea nitrogen/creatinine ratio(BUN/Cr)in acute upper gastrointestinal bleeding(UGIB).Methods:This retrospective case-control study included patients diagnosed with acute upper gastrointestinal bleeding as the case group,and selected patients without UGIB during the same period as the control group.Propensity score matching analysis(PSM)was used to balance the two groups.Multivariate logistic regression analysis was performed to determine the independent risk factors for UGIB,and receiver operating characteristic(ROC)analysis was conducted to evaluate the accuracy of BUN/Cr in diagnosing UGIB,calculating the area under the curve(AUC).Results:BUN/Cr levels were significantly higher in the case group compared to the control group[before PSM:(104.80±34.37)vs.(57.60±17.20),P<0.05];after PSM:[(105.12±33.73)vs.(58.15±17.9),P<0.05,respectively].The multivariate logistic regression analysis showed that BUN/Cr ratio,age,and male gender were independent risk factors for UGIB.(3)The ROC analysis for diagnosing UGIB had an AUC of 0.924 before UGIB and 0.914 after UGIB.(4)Higher BUN/Cr ratio was an independent risk factor for UGIB in different subgroups of gender,age,renal insufficiency,and liver cirrhosis.Conclusion:The BUN/Cr ratio has excellent diagnostic capability in acute upper gastrointestinal bleeding.
关键词
尿素氮/肌酐比值/急性上消化道出血/倾向得匹配分析/受试者工作特征曲线Key words
blood Urea Nitrogen/Creatinine Ratio/upper Gastrointestinal Bleeding/propensity score matching/receiver operating characteristic引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据