RDW、PLT、HCT与急性非静脉曲张性上消化道出血危险程度的关系及联合预测预后的效能  

The relationship between RDW,PLT,HCT and the risk degree of ANVUGIB and the effectiveness of their combination in predicting prognosis

作　　者：刘伟[1] 王贺[1] 徐丽丽 孟丽君[3] 陶萍 李建辉[1] LIU Wei;WANG He;XU Li-li;MENG Li-jun;TAO Ping;LI Jian-hui(Department of Gastroenterology, Chengde Central Hospital, Hebei Province, Chengde 067000, China;Department of General Surgery, Chengde Central Hospital, Hebei Province, Chengde 067000, China;Department of Thoracic Surgery, Chengde Central Hospital, Hebei Province, Chengde 067000, China;Department of Outpatient Surgery, Chengde Central Hospital, Hebei Province, Chengde 067000, China)

机构地区：[1]河北省承德市中心医院消化内科,河北承德067000 [2]河北省承德市中心医院普外科,河北承德067000 [3]河北省承德市中心医院心胸外科,河北承德067000 [4]河北省承德市中心医院门诊外科,河北承德067000

出　　处：《河北医科大学学报》2022年第2期145-149,共5页Journal of Hebei Medical University

基　　金：河北省医学科学研究课题计划(20200346)。

摘　　要：目的探讨红细胞分布宽度(red blood cell distribution width,RDW)、血小板计数(platelet count,PLT)、血细胞比容(hematocrit,HCT)与急性非静脉曲张性上消化道出血(acute nonvariceal upper gastrointestinal bleeding,ANVUGIB)危险程度的关系及联合预测预后的效能。方法选取我院收治的ANVUGIB患者300例,根据住院期间预后情况分为死亡组(n=26)、生存组(n=274),比较2组一般资料、RDW、PLT、HCT水平,采用Pearson分析RDW、PLT、HCT与Glasgow-Blatchford评分系统(Glasgow Blatchford Score,GBS)相关性,采用偏相关性进一步分析各指标与GBS的关系,采用受试者工作特征曲线(receiver operating characteristic curve,ROC)及ROC下面积(area under curve,AUC)分析RDW、PLT、HCT及联合预测预后的效能。结果死亡组GBS评分高于生存组(P<0.05),且2组出血量分布比较,差异有统计学意义(P<0.05);死亡组RDW高于生存组,PLT、HCT低于生存组(P<0.05);RDW与GBS评分呈正相关(r=0.601,P<0.001),PLT(r=-0.592,P<0.001)、HCT(r=-0.697,P<0.001)与GBS评分呈负相关;将出血量控制后,RDW、PLT、HCT仍与GBS评分相关(P<0.05);RDW+PLT+HCT预测预后的AUC为0.900,高于各指标单独预测。结论RDW、PLT、HCT均与ANVUGIB患者危险程度分级及预后有关,联合检测可提高预后预测价值,为采取及时、有效、个体化治疗提供依据。Objective To investigate the relationship between red blood cell distribution width(RDW),platelet count(PLT),hematocrit(HCT)and the risk degree of acute nonvariceal upper gastrointestinal bleeding(ANVUGIB)and the effectiveness of their combination in the prediction of prognosis.Methods A total of 300 ANVUGIB patients admitted to our hospital were selected and divided into death group(n=26)and survival group(n=274)according to the prognosis during hospitalization.The general data,RDW,PLT,and HCT levels in the two groups were compared.Pearson analysis was used to analyze the correlation between RDW,PLT,HCT and Glasgow-Blatchford scoring system(GBS),and partial correlation was used to further analyze the relationship between each index and GBS.Receiver operating characteristic curve(ROC)and the area under ROC curve(AUC)were used to analyze the effectiveness of RDW,PLT,HCT and their combination in predicting prognosis.Results The GBS score of the death group was higher than that of the survival group(P<0.05),and the difference in the distribution of blood loss between the two groups was statistically significant(P<0.05).The RDW of the death group was higher than that of the survival group,while the PLT and HCT were lower than those of the survival group(P<0.05).RDW was positively correlated with GBS score(r=0.601,P<0.001),PLT(r=-0.592,P<0.001),and HCT(r=-0.697,P<0.001),and were negatively correlated with GBS score.After controlling the bleeding volume,RDW,PLT and HCT were still correlated with GBS score(P<0.05).The AUC of RDW+PLT+HCT in predicting prognosis was 0.900,which was higher than that predicted by each index alone.Conclusion RDW,PLT,and HCT are all related to the risk classification and prognosis of patients with ANVUGIB.Combined detection can improve the prognostic value and provide a basis for timely,effective and individualized treatment.

关 键 词：胃肠出血 红细胞分布宽度 血小板计数 血细胞比容 

分 类 号：R573.2[医药卫生—消化系统]