血小板计数与脾面积比值和血小板计数与脾长径比值与肝硬化继发急性上消化道出血的相关性研究  

Platelet count / spleen area ratio and platelet count / spleen diameter ratio in correlation study of acute upper gastrointestinal bleeding secondary to liver cirrhosis

作　　者：周欢 郭艳 王云霞 赵剑芳 ZHOU Huan;GUO Yan;WANG Yunxia;ZHAO Jianfang(Department of Gastroenterology,the Third People's Hospital of Gansu Province,Gansu,Lanzhou,730000,China)

机构地区：[1]甘肃省第三人民医院消化内科,甘肃兰州730000

出　　处：《当代医学》2023年第28期111-115,共5页Contemporary Medicine

摘　　要：目的探讨血小板计数与脾面积比值(PC/SA)和血小板计数与脾长径比值(PC/SD)与肝硬化继发急性上消化道出血(AUGIB)的相关性。方法选取2019年6月至2020年9月于甘肃省第三人民医院急诊中心就诊的60例肝硬化继发AUGIB成年患者的作为继发AUGIB组,另选取同期60例未发生AUGIB成年肝硬化患者作为无继发AUGIB组。患者均于就诊1周内使用Olympus电子胃镜GIF进行上消化道内窥镜检查。采用Logistic回归分析肝硬化继发AUGIB的影响因素,Pearson相关分析肝硬化继发AUGIB与PC/SD与PC/SA的相关性,通过ROC预测肝硬化继发AUGIB。结果两组血清白蛋白、凝血酶原时间、PC、SD、脾厚径、PC/SD、PC/SA比较差异有统计学意义(P<0.05);两组性别、年龄、体重指数、Child-Pugh分级、血红蛋白、白细胞计数、血清胆红素、谷草转氨酶(AST)、谷丙转氨酶(ALT)比较差异无统计学意义。Logistic回归分析结果显示,PC/SD、PC/SD是肝硬化继发AUGIB的危险因素(OR>1,P<0.05);Pearson相关性分析结果显示,PC/SD、PC/SA与肝硬化继发AUGIB呈正相关(r>0,P<0.05);ROC曲线结果显示,PC/SD、PC/SA对肝硬化继发AUGIB均具有较高的预测价值,其中PC/SD预测价值最高(P<0.05)。结论PC/SA和PC/SD均可用于诊断肝硬化继发AUGIB,PC/SD、PC/SA值越高,肝硬化继发AUGIB越易发生,其中PC/SD诊断价值更高,值得临床推广应用。Objective To explore the value of platelet count/spleen area ratio(PC/SA)and platelet count/spleen diameter ratio(PC/SD)in the diagnosis of acute upper gastrointestinal bleeding(AUGIB)in patients with liver cirrhosis.Methods 60 adult patients with AUGIB secondary to cir-rhosis who were admitted to the emergency center of the Third People's Hospital of Gansu Province from June 2019 to September 2020 were select-ed as the secondary AUGIB group,and 60 adult cirrhosis patients without AUGIB during the same period were selected as the non-secondary AU-GIB group.All patients underwent upper gastrointestinal endoscopy using Olympus electronic gastroscope GIF within 1 week of treatment.Logistic regression was used to analyze the influencing factors of AUGIB secondary to cirrhosis,Pearson correlation analysis was used to analyze the correla-tion between AUGIB secondary to cirrhosis and PC/SD and PC/SA,and ROC was used to predict AUGIB secondary to cirrhosis.Results There were significant differences in serum albumin,prothrombin time,PC,SD,spleen thickness,PC/SD and PC/SA between the two groups(P<0.05);there was no significant difference in gender,age,body mass index,Child-Pugh classification,hemoglobin,white blood cell count,serum bilirubin,aspartate aminotransferase(AST)and alanine aminotransferase(ALT)between the two groups.Logistic regression analysis showed that PC/SD and PC/SD were risk factors for AUGIB secondary to cirrhosis(OR>1,P<0.05);Pearson correlation analysis showed that PC/SD and PC/SA were posi-tively correlated with AUGIB secondary to cirrhosis(r>0,P<0.05);the results of ROC curve showed that PC/SD and PC/SA had high predictive value for AUGIB secondary to cirrhosis,and PC/SD had the highest predictive value(P<0.05).Conclusion Both PC/SA and PC/SD can be used to diagnose AUGIB secondary to cirrhosis.The higher the PC/SD and PC/SA values,the more likely acute AUGIB secondary to cirrhosis occurs,PC/SD has higher diagnostic value and is worthy of clinical promotion and application.

关 键 词：血小板计数 脾面积 脾长径 肝硬化 急性上消化道出血 

分 类 号：R573.2[医药卫生—消化系统]