血清PGE-2、B/A预测急性非静脉曲张性上消化道出血患者预后的价值  

Prognostic value of serum PGE-2 and B/A in patients with acute nonvariceal upper gastrointestinal bleeding

作　　者：陈德琼 王萍[2] CHEN Deqiong;WANG Ping(School of Medicine,Jianghan University,Wuhan,Hubei 430056,China;Department of Gastroenterology,Wuhan Central Hospital,Wuhan,Hubei 430014,China)

机构地区：[1]江汉大学医学院,湖北武汉430056 [2]武汉市中心医院消化内科,湖北武汉430014

出　　处：《现代医药卫生》2023年第20期3471-3474,3478,共5页Journal of Modern Medicine & Health

摘　　要：目的 探讨急性非静脉曲张性上消化道出血(ANVUGIB)患者预后的影响因素及血清前列腺素E-2(PGE-2)、血尿素氮与清蛋白(B/A)比值预测其预后的价值。方法 回顾性分析2018年1月至2022年1月武汉市中心医院消化内科收治的150例ANVUGIB患者的临床资料,比较死亡组(17例)及存活组(133例)患者一般资料,包含年龄、性别、既往上消化道出血史、平均动脉压、脉率、血红蛋白、清蛋白、血尿素氮、B/A比值、血糖、出血原因、出血次数、Rockall分数、血清PGE-2、血乳酸等,采用单因素和多因素logistic回归研究影响ANVUGIB患者预后的因素,并采用受试者工作特征(ROC)曲线分析血清PGE-2、B/A比值预测患者预后的价值。结果 B/A比值、Rockall分数、出血次数、血清PGE-2、血乳酸均为ANVUGIB患者死亡的相关因素,其中B/A比值、血清PGE-2均为ANVUGIB患者死亡的影响因素,差异均有统计学意义(P<0.05)。血清PGE-2、B/A比值,以及二者联合预测ANVUGIB患者预后的ROC曲线下面积分别为0.877、0.887、0.966。结论 血清PGE-2、B/A比值为影响ANVUGIB患者预后的危险因素,二者联合预测ANVUGIB患者预后具有良好的应用价值,在疾病诊断时临床医师可根据患者各项指标状况进行合理判断。Objective To investigate the prognostic factors of patients with acute non variceal upper gastrointestinal bleeding(ANVUGIB)and the prognostic value of serum prostaglandin E-2(PGE-2),blood urea nitrogen(BUN)and albumin(B/A)ratio.Methods The clinical data of 150 patients with ANVUGIB who visited the Department of Gastroenterology of Wuhan Central Hospital from January 2018 to January 2022 were analyzed retrospectively.The general data of the death group(17 cases)and the survival group(133 cases)were compared,including age,gender,previous upper gastrointestinal bleeding history,average arterial pressure,pulse rate,hemoglobin,albumin,blood urea nitrogen,B/A ratio,blood glucose,bleeding cause,bleeding times,Rockall score,serum PGE-2,blood lactic acid,etc.Univariate and multivariate logistic regression were used to study the prognostic factors of ANVUGIB patients,and receiver operating characteristic(ROC)curve was used to analyze the prognostic value of serum PGE-2 and B/A ratio.Results The B/A ratio,Rockall score,bleeding times,serum PGE-2,blood lactic acid were the related factors of death in ANVUGIB patients,and B/A ratio and serum PGE-2 were the influencing factors for the death of ANVUGIB patients,the differences were statistically significant(P<0.05).The area under the ROC curve(AUC)of serum PGE-2,B/A ratio and the combination of PGE-2 and B/A to predict the prognosis of ANVUGIB patients were 0.877,0.887 and 0.966,respectively.Conclusion Serum PGE-2 and B/A ratio are risk factors affecting the prognosis of patients with ANVUGIB.The combination of the two has a good predictive value in the prognosis of patients with ANVUGIB.When diagnosing the disease,clinicians can make reasonable judgments according to the indicators of patients.

关 键 词：血清前列腺素E-2 血尿素氮与清蛋白比值 急性非静脉曲张性上消化道出血 影响因素 预后 

分 类 号：R573.2[医药卫生—消化系统] R446[医药卫生—内科学]