| 张贺媛,王 璇,王 芳,禹东连,刘雪姣.肝硬化门静脉高压患者并发上消化道出血的危险因素及RLR、TBA、PT的预测效能研究[J].,2022,(12):2377-2382 |
| 肝硬化门静脉高压患者并发上消化道出血的危险因素及RLR、TBA、PT的预测效能研究 |
| Risk Factors of Upper Gastrointestinal Bleeding in Patients with Cirrhosis Portal Hypertension and the Predictive Efficacy Study of RLR,TBA and PT |
| 投稿时间：2022-02-15 修订日期：2022-03-10 |
| DOI：10.13241/j.cnki.pmb.2022.12.036 |
| 中文关键词: 肝硬化 门静脉高压 上消化道出血 危险因素 RLR TBA PT 预测效能 |
| 英文关键词: Cirrhosis Portal hypertension Upper gastrointestinal bleeding Risk factors RLR TBA PT Predictive efficacy |
| 基金项目:北京市属医院科研培育计划项目（PX2019062）；首都医科大学附属北京佑安医院中青年人才孵育项目（YNKTHL2021010） |
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| 中文摘要: |
| 摘要 目的：分析肝硬化门静脉高压（CPH）患者并发上消化道出血（UGIB）的危险因素并探讨红细胞分布宽度与淋巴细胞比值（RLR）、总胆汁酸（TBA）、凝血酶原时间（PT）的预测效能。方法：选取2019年5月～2022年4月我院收治的150例CPH患者，根据是否并发UGIB分为UGIB组57例和非UGIB组93例。采用多因素Logistic回归分析CPH患者并发UGIB的危险因素，受试者工作特征（ROC）曲线分析RLR、TBA、PT对CPH患者并发UGIB的预测效能。结果：两组患者饮酒史比例、Child-Pugh分级、门静脉内径、食管静脉曲张程度、Hb、白蛋白、RDW、LC比较差异统计学意义（P＜0.05）。UGIB组RLR、TBA高于非UGIB组，PT长于非UGIB组（P＜0.05）。多因素Logistic回归分析显示，饮酒史、Child-Pugh C级、门静脉内径增加、重度食管静脉曲张、RLR上升、TBA上升、PT上升为CPH患者并发UGIB的独立危险因素，Hb上升为独立保护因素（P＜0.05）。ROC曲线分析显示，RLR、TBA、PT单独与联合预测CPH患者并发UGIB的曲线下面积（AUC）分别为0.804、0.779、0.786、0.920，灵敏度分别为63.16％、70.18％、59.65％、77.19％，特异度分别为94.62％、80.65％、88.17％、96.77％。RLR、TBA、PT联合预测CPH患者并发UGIB的AUC大于RLR、TBA、PT单独预测（P＜0.05）。结论：饮酒、Child-Pugh C级、门静脉内径增加、重度食管静脉曲张、RLR上升、TBA上升、PT上升是CPH患者并发UGIB的危险因素，Hb上升为保护因素，RLR、TBA、PT联合预测CPH患者并发UGIB的效能较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the risk factors of upper gastrointestinal bleeding (UGIB) in patients with cirrhosis portal hypertension (CPH), and to explore the predictive efficacy of red blood cell distribution width to lymphocyte ratio (RLR), total bile acid (TBA) and prothrombin time (PT). Methods: 150 patients with CPH who were admitted to our hospital from May 2019 to April 2022 were selected, and they were divided into UGIB group with 57 cases and non-UGIB group with 93 cases according to whether they were complicated with UGIB. Multivariate Logistic regression was used to analyze the risk factors for UGIB in patients with CPH, and receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of RLR, TBA and PT for UGIB in patients with CPH. Results: There were statistically significant differences in proportion of drinking history, Child-Pugh grade, portal vein diameter, degree of esophageal varices, Hb, albumin, RDW and LC between two groups (P＜0.05). RLR and TBA in UGIB group were higher than those in non-UGIB group, and PT was longer than that in non-UGIB group (P＜0.05). Multivariate Logistic regression analysis showed that drinking history, Child-Pugh grade C, increased portal vein diameter, severe esophageal varicos, increased RLR, increased TBA, increased PT were the independent risk factors for UGIB in patients with CPH, and increased Hb as independent protective factors (P＜0.05). ROC curve analysis showed that the area under curve (AUC) of RLR, TBA and PT alone and in combination for predicting UGIB in patients with CPH were 0.804, 0.779, 0.786 and 0.920 respectively, and the sensitivities were 63.16%, 70.18%, 59.65% and 77.19%, respectively. The specificity was 94.62%, 80.65%, 88.17% and 96.77%, respectively. The AUC of patients with CPH complicated with UGIB predicted by RLR, TBA and PT combined was greater than that predicted by RLR, TBA and PT alone (P＜0.05). Conclusion: Alcohol consumption, Child-Pugh grade C, increased portal vein diameter, severe esophageal varicos, increased RLR, increased TBA, increased PT are the risk factors for UGIB in patients with CPH, and increased Hb as a protective factors. The RLR, TBA and PT combined predict UGIB in patients with CPH with high efficacy. |
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