休克指数预测急性上消化道出血患者预后的价值  

Predictive Value of Shock Index on Prognosis of Patients with Acute Upper Gastrointestinal Hemorrhage

作　　者：周益民 陈荣琳[2] 龚中明 黄桂平 Zhou Yi-min;Chen Rong-lin;Gong Zhong-ming;Huang Gui-ping(Shantou University Medical College,Shantou 515000,Guangdong Province,China;Shenzhen Longgang Central Hospital,Shenzhen 518100,Guangdong Province,China;Shenzhen Longgang District Fifth People's Hospital,Shenzhen 518111,Guangdong Province,China)

机构地区：[1]汕头大学医学院,广东汕头515000 [2]深圳市龙岗中心医院,广东深圳518100 [3]深圳市龙岗区第五人民医院,广东深圳518111

出　　处：《中国社区医师》2023年第5期115-117,120,共4页Chinese Community Doctors

摘　　要：目的:探讨不同休克指数(SI)预测急性上消化道出血患者预后的价值。方法:回顾性分析2017年1月—2021年12月深圳市龙岗区第五人民医院收治的320例急性上消化道出血患者的临床资料,计算各项SI,30 d内进行预后随访,分为预后良好组和预后不良组。比较两组一般资料,分析不同SI预测急性上消化道出血不良预后的价值,统计不同SI的Spearman相关性分析。结果:两组性别、年龄、体温比较,差异无统计学意义(P>0.05);预后良好组患者心率低于预后不良组,收缩压、舒张压高于预后不良组,差异有统计学意义(P<0.05)。ROC曲线显示,SI、改良休克指数(MSI)、体温调整休克指数[ASI(T)]、年龄休克指数(Age-SI)、rSIG休克指数(rSIG-SI)及rSIG/A休克指数(rSIG/A-SI)均可预测急性上消化道出血不良预后,差异有统计学意义(P<0.05)。Spearman相关性分析提示,SI、MSI、ASI(T)、Age-SI之间呈显著正相关关系,差异有统计学意义(P<0.05);rSIG-SI、rSIG/A-SI之间呈显著正相关关系,差异有统计学意义(P<0.05);SI、MSI、ASI(T)、Age-SI与rSIG-SI、rSIG/A-SI呈显著负相关关系,差异有统计学意义(P<0.05)。结论:SI、MSI、ASI(T)、Age-SI、rSIG-SI及rSIG/A-SI均能预测急性上消化道出血患者不良预后,MSI的诊断价值高于Age-SI。Objective:To investigate the value of different shock indexes(SI)in predicting the prognosis of patients with acute upper gastrointestinal hemorrhage.Methods:A retrospective analysis was carried out on the clinical data of 320 patients with acute upper gastrointestinal hemorrhage who were admitted to Shenzhen Longgang District Fifth People's Hospital from January 2017 to December 2021.The various SIs were calculated.The prognosis was followed up within 30 days,and the patients were divided into good prognosis group and poor prognosis group.The general data were compared between two groups.The value of different SIs in predicting poor prognosis of acute upper gastrointestinal hemorrhage was analyzed.Spearman correlation analysis of different SIs was statistically analyzed.Results:There were no significant differences in gender,age and body temperature between the two groups(P>0.05).The heart rate of patients in the good prognosis group was lower than that in the poor prognosis group,and the systolic blood pressure and diastolic blood pressure in the good prognosis group were higher than those in the poor prognosis group,and the difference was statistically significant(P<0.05).The ROC curve showed that SI,modified shock index(MSI),temperature-adjusted shock index[ASI(T)],age shock index(Age-SI),rSIG shock index(rSIG-SI)and rSIG/A shock index(rSIG/A-SI)could predict the poor prognosis of acute upper gastrointestinal hemorrhage,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that,there was a significant positive correlation between SI,MSI,ASI(T)and Age-SI,and the difference was statistically significant(P<0.05).There was a significant positive correlation between rSIG-SI and rSIG/A-SI,and the difference was statistically significant(P<0.05).There was a significant negative correlation between SI,MSI,ASI(T),Age-SI and rSIG-SI,rSIG/A-SI,and the differences were statistically significant(P<0.05).Conclusion:SI,MSI,ASI(T),Age-SI,rSIG-SI and rSIG/A-SI can predict the poor progn

关 键 词：休克指数 急性上消化道出血 预后 

分 类 号：R573.2[医药卫生—消化系统]