肝硬化合并食管胃底静脉曲张出血患者RDW-CV与Child-Pugh分级的关系  

RDW-CV and Child-Pugh score incirrhotic patients with bleeding in esophageal and gastric varices

作　　者：陈燕[1] 付冲 李敏[1] 张焰平[1] CHEN Yan;FU Chong;LI Min;ZHANG Yanping(Department of Gastroenterology,Anqing Hospital Affiliated to Anhui Medical University,Anqing 246000,China)

机构地区：[1]安徽医科大学附属安庆医院消化内科,安徽安庆246000

出　　处：《皖南医学院学报》2021年第2期153-156,共4页Journal of Wannan Medical College

基　　金：安庆市2018年第二批自筹经费科技计划项目(2018Z2001)。

摘　　要：目的:探讨红细胞分布宽度(RDW)与食管胃底静脉曲张破裂出血患者的肝硬化严重程度之间的关系。方法:选取安徽医科大学附属安庆医院收治的175例肝硬化合并食管胃底静脉曲张破裂出血的住院患者,根据Child-Pugh分级分为A级、B级和C级,检测并比较3组研究对象间红细胞体积大小的变异系数(RDW-CV)的水平,采用受试者工作曲线(ROC)分析RDW-CV检测对不同程度肝硬化患者的诊断能力并计算两者之间的相关性。结果:Child-Pugh评分值与RDW-CV呈正相关(r=0.326,P<0.01)。以14.85%作为RDW-CV判断Child-Pugh A与B的最佳截断点,由此得出其对应灵敏度、特异度、ROC曲线下面积(AUC)分别为0.844、0.384、0.580;以17.40%作为RDW-CV判断Child-Pugh B与C的最佳截断点,由此得出其对应灵敏度、特异度、AUC为0.600、0.818、0.697。结论:RDW-CV与食管胃底静脉曲张破裂出血患者肝硬化严重程度呈正相关;RDW-CV是评估食管胃底静脉曲张破裂出血患者的肝硬化严重程度的潜在指标。Objective:To investigate the relationship between coefficient of variation of red blood cell distribution width(RDW-CV)and the severity of cirrhotic patients with bleeding in esophageal and gastric varices.Methods:Totally,175 cirrhotic patients of bleeding in esophageal and gastric varices were included,and divided into groups of Child-Pugh A,B and C.RDW-CV was measured and compared among the patients in the three groups.Receiver operating characteristic(ROC)curve was used to estimate the diagnostic ability of RDW-CV in severity of liver cirrhosis,and the correlation between RDW-CV and severity of liver cirrhosis was analyzed by Person method.Results:Child-Pugh scores were correlated with RDW-CV(r=0.326,P<0.01).By the best cut-off value of RDW-CV being 14.85%in the diagnosis of Child-Pugh A and B,the predictive sensitivity,specificity and area under curve(AUC)were 0.844,0.384 and 0.580,respectively,whereas the predictive sensitivity,specificity and AUC were 0.600,0.818 and 0.697,respectively,based on 17.40%as the best cut-off value of RDW-CV for Child-Pugh B and C.Conclusion:RDW-CV is positively correlated with the severity of liver cirrhosis in patients complicated with bleeding in esophageal and gastric varices,and can be served as a potential indicator to evaluate the severity of this condition.

关 键 词：红细胞分布宽度 食管胃底静脉曲张破裂出血 CHILD-PUGH评分 

分 类 号：R575.2[医药卫生—消化系统] R571.3[医药卫生—内科学]