| APRI联合AIMS65评分对肝硬化伴上消化道出血预后的预测价值 |
| 投稿时间：2024-10-23 修订日期：2024-11-18 点此下载全文 |
| 引用本文：许迎秀,赵丹丹,吴克俭.APRI联合AIMS65评分对肝硬化伴上消化道出血预后的预测价值[J].医学研究杂志,2025,54(4):157-163, 11 |
| DOI：
10.11969/j.issn.1673-548X.2025.04.028 |
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| 中文摘要:目的 研究天门冬氨酸氨基转移酶与血小板比值(aspartate aminotransferase to platelet ratio index, APRI)联合AIMS65评分对肝硬化伴上消化道出血(upper gastrointestinal bleeding, UGIB)患者6周内死亡及再出血的预测价值。方法 回顾性收集2019年6月~2024年4月于徐州医科大学附属医院就诊的302例肝硬化伴UGIB患者的临床资料,采用二元Logistic回归分析6周内死亡以及再出血的独立危险因素,并绘制受试者工作特征(receiver operating characteristic, ROC)曲线,计算曲线下面积(area under the curve, AUC),比较其预测6周内死亡及再出血效能。结果 单因素及多因素Logistic回归分析显示APRI及AIMS65评分是肝硬化伴UGIB 6周内死亡的独立危险因素；ROC曲线显示,APRI联合AIMS65评分的AUC值高于APRI、AIMS65评分、Child-Pugh评分、MELD评分(P＜0.05),其AUC值分别为0.889、0.775、0.859、0.832、0.735。既往出血史、APRI及AIMS65评分是肝硬化伴UGIB 6周内再出血的独立危险因素；ROC曲线显示APRI、AIMS65评分、Child-Pugh评分、MELD评分及APRI联合AIMS65评分的AUC值分别为0.709、0.729、0.735、0.688、0.774,且APRI联合AIMS65评分的预测效能优于APRI、AIMS65评分、MELD评分(P＜0.05)。结论 APRI及AIMS65评分是肝硬化伴UGIB 6周内死亡及再出血的独立危险因素,二者联合对肝硬化伴UGIB患者短期预后具有更好的预测价值。 |
| 中文关键词:肝硬化 上消化道出血 APRI AIMS65评分 预后 |
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| Prognostic Value of APRI Combined with AIMS65score in Predicting Prognosis of Liver Cirrhosis with Upper Gastrointestinal Bleeding. |
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| Abstract:Objective To study the predictive value of aspartate aminotransferase to platelet ratio index (APRI) combined with AIMS65score for death and rebleeding within 6 weeks in patients with cirrhosis with upper gastrointestinal bleeding (UGIB). Methods The clinical data of 302 patients with cirrhosis with UGIB who attended the Affiliated Hospital of Xuzhou Medical University from June 2019 to April 2024 were retrospectively collected. Binary Logistic regression was used to analyse the independent risk factors for death within 6 weeks and rebleeding. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated to compare its efficacy in predicting death and rebleeding within 6 weeks. Results Univariate and multivariate Logistic regression analyses showed that APRI and AIMS65score were independent risk factors for death within 6 weeks in cirrhosis with UGIB; ROC curves showed that the AUC values of APRI combined with AIMS65score were higher than those of APRI, AIMS65score, Child-Pugh score, and MELD score (P < 0.05), and their AUC values were 0.889,0.775,0.859,0.832 and 0.735. History of previous bleeding, APRI, and AIMS65score were independent risk factors for rebleeding within 6 weeks in cirrhosis with UGIB; ROC curves showed that the AUC values of APRI, AIMS65score, Child-Pugh score, MELD score, and APRI combined with AIMS65score had AUC values of 0.709,0.729,0.735,0.688 and 0.774, respectively. And the predictive efficacy of APRI combined with AIMS65score was better than that of APRI, AIMS65score, and MELD score (P<0.05). Conclusion APRI and AIMS65score are independent risk factors for death and rebleeding within 6 weeks in cirrhosis with UGIB, and the combination of the two has better predictive value for the short-term prognosis of patients with cirrhosis with UGIB. |
| keywords:Cirrhosis Upper gastrointestinal bleeding APRI AIMS65score Prognosis |
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