老年肝硬化门静脉高压伴上消化道急性出血预后与血细胞参数及BUN/Cr比值、 PALBI评分的关系分析  

An Association Study of Blood Cell Parameters and BUN/Cr Parametersand PALBI Score in Elderly Liver Cirrhosis

作　　者：何正琼 张伟 杜桂鹏 HE Zhengqiong;ZHANG Wei;DU Guipeng(Department of Critical Care Medicine,the Second Affiliated Hospital of Chengdu MedicalCollege(416th Hospital of Nuclear Industry),Chengdu 610000,China)

机构地区：[1]成都医学院第二附属医院(核工业四一六医院)重症医学科,四川成都610000

出　　处：《标记免疫分析与临床》2023年第12期2036-2041,共6页Labeled Immunoassays and Clinical Medicine

基　　金：四川省中医药管理局研发资金项目(编号:2021MS374)。

摘　　要：目的探讨老年肝硬化门静脉高压伴上消化道急性出血预后与血细胞参数、血尿素氮/肌酐(BUN/Cr)比值和肝病分级评分(PALBI)的关系。方法选取2017年3月至2022年3月在我院进行治疗的92例老年肝硬化门静脉高压伴上消化道急性出血患者作为研究组,另选50例未发生上消化道出血的老年肝硬化门静脉高压患者为对照组,记录患者的红细胞分布宽度(RDW)、血小板(PLT)、红细胞压积(HCT)水平,对患者的血尿素氮、肌酐水平进行分析,采用PALBI评分对患者的生存预后进行预测分析。对研究组患者进行随访1年,根据患者的预后情况将其分为生存组和死亡组,比较其血细胞参数、BUN/Cr比值、PALBI评分差异。结果与对照组患者相比较,研究组患者的RDW、MPV水平升高,PLT、HCT、PCT水平降低(P<0.05)。与对照组患者相比较,研究组患者的BUN水平、Cr水平、BUN/Cr值及PALBI评分均升高(P<0.05)。经Pearson相关系数分析,患者的PALBI评分与BUN水平、Cr水平、BUN/Cr值、RDW水平均呈正相关(r=0.241,P=0.004;r=0.259,P=0.002;r=0.987,P<0.001;r=0.166,P=0.048),与PLT、HCT水平呈负相关(r=-0.207,P=0.014;r=-0.576,P<0.001)。随访期结束时,研究组92例患者有32例患者死亡,纳入死亡组,其他60例患者纳入生存组。与生存组患者相比较,死亡组患者的RDW、MPV水平升高,PLT、HCT、PCT水平降低(P<0.05)。与生存组患者相比较,死亡组患者的BUN水平、Cr水平、BUN/Cr值及PALBI评分均升高(P<0.05)。结论血细胞参数、BUN/Cr比值和PALBI评分在老年肝硬化门静脉高压伴上消化道急性出血的预后评估中具有重要的临床意义,可为预测患者的生存情况提供有价值的参考。Objective To investigate the relationship between the prognosis of portal hypertension with upper gastrointestinal acute bleeding in elderly cirrhosis and blood cell parameters,blood urea nitrogen/creatinine(BUN/Cr)ratio,and liver disease grading score(PALBI).Methods A total of 92 elderly patients with portal hypertension with upper gastrointestinal bleeding treated in our hospital from March,2017 to March,2022 were enrolled as the study group,while 50 elderly patients with portal hypertension without upper gastrointestinal bleeding were selected as the control group.All subjects were recorded for red blood cell distribution width(RDW),platelet(PLT),and hematocrit(HCT)for blood urea nitrogen and creatinine levels,and the survival prognosis was predicted by PALBI score.Patients in the study group were followed for one year and divided into survival and death groups according to their prognosis,and the differences in blood cell parameters,BUN/Cr ratio,and PALBI score were evaluated.Results Compared with the control group,RDW,MPV and PLT,HCT and PCT were increased in the study group(P<0.05).BUN levels,Cr level,BUN/Cr values and PALBI scores were increased in the study group(P<0.05).Person correlation coefficient analysis showed that PALBI scores were positively correlated with BUN level,while Cr level,BUN/Cr value,and RDW level(r=0.241,P=0.004;r=0.259,P=0.002;r=0.987,P<0.001;r=0.166,P=0.048)were negatively correlated with PLT and HCT levels(r=-0.207,P=0.014;r=-0.576,P<0.001).At the end of the follow-up period,32 patients of the 92 patients in the study group died and were included in the death group,and the other 60 patients were included in the survival group.Compared with the patients in the survival group,RDW,MW and PLT,HCT and PCT were decreased for patients in the death group(P<0.05).BUN levels,Cr levels,BUN/Cr values,and PALBI scores were higher in the death group(P<0.05).Conclusion Blood cell parameters,BUN/Cr ratio and PALBI score have important clinical significance in the prognostic evaluation of portal hy

关 键 词：老年肝硬化 门静脉高压 上消化道出血 血细胞参数 血尿素氮/肌酐比值 

分 类 号：R657.31[医药卫生—外科学]