中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2011年
9期
591-593
,共3页
高血压,门静脉%血清白蛋白%腹水%食管和胃静脉曲张%胃肠出血%ROC曲线
高血壓,門靜脈%血清白蛋白%腹水%食管和胃靜脈麯張%胃腸齣血%ROC麯線
고혈압,문정맥%혈청백단백%복수%식관화위정맥곡장%위장출혈%ROC곡선
Hypertension,portal%Serum albumin%Ascites%Esophageal and gastric varices%Gastrointestinal hemorrhage%receiver operating characteristic curve
目的 筛选食管胃底静脉曲张破裂出血的危险因素，为预测曲张静脉破裂出血提供更为经济且创伤更小的手段。方法 选取诊断明确的肝硬化腹水患者108例，肝硬化合并原发性肝癌患者60例。追踪随访1年,观察其发生食管胃底静脉曲张破裂出血的情况，并运用统计学方法进行分析。结果 单因素非条件Logistic回归分析显示腹水白蛋白、血清腹水白蛋白梯度(SAAG)、血小板、部分凝血活酶时间(APTT)、门静脉宽度、脾脏长度和厚度是危险因素，年龄和血白蛋白是保护因素。多因素分析显示SAAG、APTT和门静脉宽度是独立危险因素,OR值分别为3.559、2.468和2.608。构建受试者工作特征曲线后，SAAG取值18.50 g/L时为最佳临界值，敏感度和特异度分别为96.3％和56.3％。结论 SAAG对预测食管胃底静脉曲张破裂出血具有较好的价值。
目的 篩選食管胃底靜脈麯張破裂齣血的危險因素，為預測麯張靜脈破裂齣血提供更為經濟且創傷更小的手段。方法 選取診斷明確的肝硬化腹水患者108例，肝硬化閤併原髮性肝癌患者60例。追蹤隨訪1年,觀察其髮生食管胃底靜脈麯張破裂齣血的情況，併運用統計學方法進行分析。結果 單因素非條件Logistic迴歸分析顯示腹水白蛋白、血清腹水白蛋白梯度(SAAG)、血小闆、部分凝血活酶時間(APTT)、門靜脈寬度、脾髒長度和厚度是危險因素，年齡和血白蛋白是保護因素。多因素分析顯示SAAG、APTT和門靜脈寬度是獨立危險因素,OR值分彆為3.559、2.468和2.608。構建受試者工作特徵麯線後，SAAG取值18.50 g/L時為最佳臨界值，敏感度和特異度分彆為96.3％和56.3％。結論 SAAG對預測食管胃底靜脈麯張破裂齣血具有較好的價值。
목적 사선식관위저정맥곡장파렬출혈적위험인소，위예측곡장정맥파렬출혈제공경위경제차창상경소적수단。방법 선취진단명학적간경화복수환자108례，간경화합병원발성간암환자60례。추종수방1년,관찰기발생식관위저정맥곡장파렬출혈적정황，병운용통계학방법진행분석。결과 단인소비조건Logistic회귀분석현시복수백단백、혈청복수백단백제도(SAAG)、혈소판、부분응혈활매시간(APTT)、문정맥관도、비장장도화후도시위험인소，년령화혈백단백시보호인소。다인소분석현시SAAG、APTT화문정맥관도시독립위험인소,OR치분별위3.559、2.468화2.608。구건수시자공작특정곡선후，SAAG취치18.50 g/L시위최가림계치，민감도화특이도분별위96.3％화56.3％。결론 SAAG대예측식관위저정맥곡장파렬출혈구유교호적개치。
Objective To screen the risk factors of esophageal-gastric fundus variceal bleeding,in order to provide a more economical and less invasive method for predicting esophageal-gastric fundus variceat bleeding. Methods A total of 168 diagnosed liver cirrhosis patients accompanied with ascites and 60 cases of liver cirrhosis patients with primary hepatic carcinoma were enrolled. Followed up for one year, the esophageal-gastric fundus variceal bleeding was observed and analyzed with statistic methods. Results Unconditional single factor logistic regression model analysis indicated that albumin level of ascites, serum-ascites albumin gradients (SAAG), platelets, activated partial thromboplastin time (APTT), portal vein width, length and thickness of the spleen were independent risk factors,age and serum albumin were protective factors. Multifactor analysis indicated SAAG, APTT, and portal vein width were the independent risk factors, OR was 3.559 , 2.468 and 2. 608 respectively.After building receiver operating characteristic curve, the best SAAG cut-off value was 18.50 g/L, of which the sensitivity was 96.3％ and specificity was 56.3％. Conclusion SAAG has good value in predicting esophageal-gastric fundus variceal bleeding.
