ABR指数在肝硬化食管静脉曲张破裂出血患者的应用价值研究  

Applicational value of adjusted blood requirement index in patients with cirrhotic esophageal variceal bleeding

作　　者：金燕[1] 孙源源[1] 张振中[1] 朱陈[1] 陈建[1] 

机构地区：[1]南通大学附属南通第三医院消化内科,226006

出　　处：《齐齐哈尔医学院学报》2010年第14期2198-2199,共2页Journal of Qiqihar Medical University

摘　　要：目的研究ABR指数在肝硬化食管静脉曲张破裂出血(CEVB)患者的应用价值。方法回顾分析2006年3月～2010年3月CEVB患者的临床资料。统计血管活性药物的使用(奥曲肽或血管加压素)、内镜下套扎情况和临床结局(存活或死亡)。比较不同干预措施及临床结局的ABR指数,利用ROC曲线评价ABR指数对临床结局的预测价值,对ABR指数与临床结局进行相关性分析。结果不同干预措施间ABR指数无显著统计学意义(P>0.05);死亡患者ABR指数高于存活患者,两组间比较差异有统计学意义(P<0.05)。ABR指数预测死亡的ROC曲线显示曲线下面积0.801,差异有显著统计学意义(P<0.05,95%CI:0.708～0.894),最佳临界值为0.748,敏感度92.0%,特异度62.5%。pearson双变量相关分析显示ABR指数与死亡存在相关性(r=0.26,P<0.05)。结论 ABR指数能较好地预测CEVB的临床结局,与死亡存在显著相关性,不同干预措施间并未发现ABR指数有何差异。Objective To evaluate the applicational value of adjusted blood requirement index（ABRI） in patients with cirrhotic esophageal variceal bleeding（CEVB）. Methods The medical documents of CEVB patients were reviewed retrospectively from March 2006 to March 2010. Use of vasoactive agents（pituitrin or octreotide）,endoscopic variceal ligation（EVL）and outcome（survival or death）were collected. ABRI were compared according to different interventions and outcome.The predictive value of ABRI for clinical outcome was evaluated by using receiver operative characteristic（ROC） curves. The correlation between ABRI and clinical outcome was estimated.Results There were no significant difference between the different interventions（P〈0.05）. Compared with the survivals,the ABRI of the dead patients was higher（P〉0.05）. The ROC curve of ABRI for death showed a significantly large area of 0.801 （P〈0.05;95% CI：0.705-0.894）. The most appropriate ABRI cut-off value was 0.748（with sensitivity 92.0%,specificity 62.5%）. Pearson＇s Bivariate Correlation test showed a significant correlation between ABRI and mortality（r=0.26,P〈0.05）.Conclusions ABRI can predict the clinical outcome of CEVB effectively. ABRI correlated significantly with death. No significant difference of ABRI has been found between the different interventions.

关 键 词：ABR指数 食管静脉曲张破裂出血 肝硬化 

分 类 号：R259.752[医药卫生—中西医结合]