三种内镜前评分系统对危险性急性上消化道出血预后评估的比较  

Comparison of three pre-endoscopic scoring systems for prognosis evaluation of high risk acute upper gastrointestinal bleeding

作　　者：李玥[1] 胡祥鹏[1] 章礼久[1] LI Yue;HU Xiang-peng;ZHANG Li-jiu(Department of Gastroenterology,The Second Affiliated Hospital of Anhui Medical University,Hefei Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院消化内科,安徽合肥230601

出　　处：《蚌埠医学院学报》2022年第8期1026-1029,共4页Journal of Bengbu Medical College

基　　金：安徽医科大学校科研基金项目(2021xkj044)。

摘　　要：目的:探讨三种内镜前评分系统AIMS65、Glasgow-Blachford(GBS)及Pre-Rockall在危险性急性上消化道出血(AUGIB)病人预后中的评估价值。方法:回顾性分析299例危险性AUGIB病人的临床资料,回顾诊断及治疗结局。以院内死亡或30 d内死亡、再出血为终点指标,绘制ROC曲线,比较曲线下面积(AUC),评估三种评分系统对预后的评估价值。结果:299例危险性AUGIB病人,行紧急胃镜(0~12 h)的病人病死率高于行13~24 h和>24 h胃镜检查病人,差异存在统计学意义(P<0.05)。在预测院内死亡/30 d内死亡率方面,AMIS65、Pre-Rocall、GBS评分系统的AUC分别为0.820、0.812、0.516,其中AMIS65最优,其次为Pre-Rocall,二种评分系统能力相当(P>0.05)。在预测院内/30 d内再出血方面,AMIS65、Pre-Rocall、GBS评分系统的AUC分别为0.729、0.676、0.511,其中AMIS65最优,其次为Pre-Rocall,二种评分系统能力相当(P>0.05)。在预测输血方面,AMIS65、Pre-Rocall、GBS评分系统的AUC分别为0.709、0.591、0.646,其中AMIS65最优,其次为GBS,二种评分系统能力相当(P>0.05)。结论:AIMS65、Pre-Rockall能准确预测病人死亡率及再出血率,适用于危险性AUGIB的内镜前风险评估。Objective:To explore the prognostic value of three pre-endoscopic scoring systems AIMS65,Glasgow-Blachford(GBS) and Pre-Rockall in patients with high risk acute upper gastrointestinal bleeding(AUGIB).Methods:Clinical data of 299 patients with high risk AUGIB were retrospectively analyzed,and the diagnosis and treatment outcome were reviewed.The death in hospital or death and rebleeding within 30 days were taken as the study endpoints.The ROC curve was draw,and area under the curve(AUC) was compared.Clinical values among the three scores were evaluated by ROC and AUC.Results:The mortality of patients undergoing emergency gastroscopy in 0-12 h was higher than patients undergoing emergency gastroscopy in 13-24 h and >24 h(P0.05).In predicting in-hospital or 30-day rebleeding,the AUC of AMIS65,Pre-Rocall and GBS were 0.729,0.676 and 0.511,respectively,the AMIS65 was best,followed by Pre-Rocall,there were no significant differences between the two scored(P>0.05).In predicting blood transfusion,the AUC of AMIS65,Pre-Rocall and GBS were 0.709,0.591 and 0.646,respectively,the AMIS65 was best,followed by GBS,there were no significant differences between the two scored(P>0.05).Conclusions:AIMS65 and Pre-Rockall can accurately predict the mortality rate and rebleeding rate of patients,which are suitable for pre-endoscopic assessment of high risk AUGIB.

关 键 词：急性上消化道出血 AIMS65评分 Pre-Rockall评分 Glasgow-Blachford评分 

分 类 号：R573.2[医药卫生—消化系统]