多种评分系统评估食管静脉曲张破裂出血患者住院30天预后的临床价值(1)
摘要：目的 评价CTP评分、MELD-Na评分及iMELD评分在判断食管静脉曲张破裂出血患者住院30天预后的临床价值。方法 回顾性分析2015年1月～2017年8月因肝硬化食管静脉曲张破裂出血在我院住院的患者76例的病历资料。分别计算其入院首次的CTP评分、MELD-Na评分及iMELD评分。以入院30天内的最后结局好转或死亡为研究终点，以此分为死亡组與生存组。用受试者工作曲线(ROC)曲线下面积(AUC)比较3种方法对结局的预测能力。计算CTP评分、MELD-Na评分及iMELD评分判断预后的最佳界值点。结果 死亡组与生存组患者CTP评分、MELD-Na评分及iMELD评分分值比较(7.16±1.19)分vs(10.95±1.61)分、(7.79±4.79)分vs(24.29±8.98)分、(25.97±5.73)分vs(41.81±8.13)分，差异有统计学意义(P<0.05)。在判断患者预后的AUC比较中， MELD-Na评分(0.97)最好，其次是CTP评分(0.96)，优于iMELD评分(0.95)。CTP评分、MELD-Na评分、iMELD评分最佳界值点是分别是9.5、14、29.8。结论 CTP评分、MELD-Na评分及iMELD评分能较好预测食管静脉曲张破裂出血患者住院30天内死亡，其中MELD-Na评分最佳。
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关键词：食管静脉曲张破裂出血;预后评分;CTP评分;MELD-Na评分;iMELD评分
中图分类号：R571+.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.06.033
文章编号：1006-1959(2019)06-0108-03
Abstract：Objective To evaluate the clinical value of CTP score， MELD-Na score and iMELD score in the prognosis of 30-day hospitalization in patients with esophageal varices bleeding. Methods The medical records of 76 patients admitted to our hospital from January 2015 to August 2017 due to cirrhosis of esophageal varices were retrospectively analyzed. The first CTP score， MELD-Na score and iMELD score of the admission were calculated. The final outcome was improved or died within 30 days of admission as the study end point， which was divided into death group and survival group.The predictive power of the outcomes of the three methods was compared using the area under the receiver operating curve (ROC) curve (AUC). Calculate the CTP score， MELD-Na score and iMELD score to determine the best cut-off point of prognosis. Results The CTP score， MELD-Na score and iMELD score of the death group and the survival group were compared (7.16±1.19)， vs. (10.95±1.61)， (7.79±4.79)， vs. (24.29±8.98)， (25.97). ±5.73) points vs. 41.81±8.13 points， the difference was statistically significant (P<0.05). The MELD-Na score (0.97) was the best in the AUC comparison to judge the prognosis of patients， followed by the CTP score (0.96)， which was superior to the iMELD score (0.95). The best cut-off points for the CTP score， MELD-Na score， and iMELD score were 9.5， 14， and 29.8， respectively. Conclusion CTP score， MELD-Na score and iMELD score can better predict the death of patients with esophageal varices bleeding within 30 days of hospitalization， among which MELD-Na score is the best., 百拇医药(曾丽妮 吴伟东)
, http://www.100md.com
关键词：食管静脉曲张破裂出血;预后评分;CTP评分;MELD-Na评分;iMELD评分
中图分类号：R571+.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.06.033
文章编号：1006-1959(2019)06-0108-03
Abstract：Objective To evaluate the clinical value of CTP score， MELD-Na score and iMELD score in the prognosis of 30-day hospitalization in patients with esophageal varices bleeding. Methods The medical records of 76 patients admitted to our hospital from January 2015 to August 2017 due to cirrhosis of esophageal varices were retrospectively analyzed. The first CTP score， MELD-Na score and iMELD score of the admission were calculated. The final outcome was improved or died within 30 days of admission as the study end point， which was divided into death group and survival group.The predictive power of the outcomes of the three methods was compared using the area under the receiver operating curve (ROC) curve (AUC). Calculate the CTP score， MELD-Na score and iMELD score to determine the best cut-off point of prognosis. Results The CTP score， MELD-Na score and iMELD score of the death group and the survival group were compared (7.16±1.19)， vs. (10.95±1.61)， (7.79±4.79)， vs. (24.29±8.98)， (25.97). ±5.73) points vs. 41.81±8.13 points， the difference was statistically significant (P<0.05). The MELD-Na score (0.97) was the best in the AUC comparison to judge the prognosis of patients， followed by the CTP score (0.96)， which was superior to the iMELD score (0.95). The best cut-off points for the CTP score， MELD-Na score， and iMELD score were 9.5， 14， and 29.8， respectively. Conclusion CTP score， MELD-Na score and iMELD score can better predict the death of patients with esophageal varices bleeding within 30 days of hospitalization， among which MELD-Na score is the best., 百拇医药(曾丽妮 吴伟东)