首页|基于白蛋白-胆红素指数构建肝硬化并发急性上消化道出血的预测模型

基于白蛋白-胆红素指数构建肝硬化并发急性上消化道出血的预测模型

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目的:探讨白蛋白-胆红素(ALBI)指数对肝硬化患者并发急性上消化道出血的预测价值,并建立相关预测模型.方法:选取2019年12月至2022年12月收治的肝硬化患者并发急性上消化道出血作为研究对象,收集患者临床资料,采用ROC曲线评估ALBI指数的预测价值,并计算最佳截断值.采用单因素和多因素Logistic回归分析肝硬化患者并发急性上消化道出血的影响因素,并据此建立列线图模型.结果:ALBI指数预测肝硬化患者并发急性上消化道出血的ROC曲线下面积为0.764(95%CI=0.693~0.835).病程较长、腹水、Ca<2.2 mmol/L、PT≥16 s、PLT<100 × 109/L和ALBI指数≥-1.87是肝硬化患者并发急性上消化道出血的独立危险因素(P<0.05).据此建立预测肝硬化患者并发急性上消化道出血风险的列线图模型,模型验证结果显示一致性指数(C-index)为0.854,校准曲线趋近于理想曲线,ROC曲线的AUC为0.851(95%CI=0.823~0.879),在5%~96%预测范围内模型净获益.结论:ALBI指数对肝硬化患者并发急性上消化道出血具有较高的预测价值,基于ALBI指数构建的列线图模型能够有效预测该类患者的风险.
Practical exploration of constructing a predictive model for acute upper gastrointestinal bleeding in patients with liver cirrhosis based on the albumin bilirubin index
Objective:To explore the predictive value of albumin-bilirubin(ALBI)index for acute upper gastrointestinal bleeding in patients with liver cirrhosis,and to establish relevant predictive models.Methods:Choose between December 2019 and December 2022 were complicated with acute upper gastrointestinal bleeding in patients with cirrhosis as the research object,collect patients clinical data,using ROC curve to assess the predictive value of ALBI index,and calculate the optimal cutoff value.Univariate and multivariate Logistic regression were used to analyze the influencing factors of patients with liver cirrhosis complicated with acute upper gastrointestinal bleeding,and a nomogram model was established accordingly.Results:The area under the ROC curve predicted by ALBI index for cirrhosis patients with acute upper gastrointestinal bleeding was 0.764(95%CI:0.693-0.835).Long course of disease,ascites,Ca<2.2 mmol/L,PT≥ 16 s,PLT<100 x 109/L and ALBI index-1.87 were independent risk factors for acute upper gastrointestinal bleeding in patients with liver cirrhosis(P<0.05).Based on this,a nomogram model was established to predict the risk of acute upper gastrointestinal bleeding in patients with liver cirrhosis.The model validation results showed that the C-index was 0.854,the calibration curve approached the ideal curve,and the AUC of the ROC curve was 0.851(95%CI:0.823-0.879).Within the prediction range of 5%to 96%,the model had a net benefit.Conclusion:ALBI index has high predictive value for liver cirrhosis patients with acute upper gastrointestinal bleeding,and the column chart model constructed based on ALBI index can effectively predict the risk of liver cirrhosis patients with acute upper gastrointestinal bleeding.

albumin-bilirubin indexcirrhosisacute upper gastrointestinal bleedingnomogram

郑丹梅、韦国华、王燕、肖璇

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简阳市人民医院急诊科(四川 成都,641400)

肝硬化 急性上消化道出血 白蛋白-胆红素指数 列线图

2024

中西医结合肝病杂志
中国中西医结合学会,湖北中医学院

中西医结合肝病杂志

CSTPCD
影响因子:0.908
ISSN:1005-0264
年,卷(期):2024.34(6)