肝硬化上消化道出血患者血清血小板生成素、前列腺素E2水平与病情严重程度和预后的关系  

Relationship between the expression levels of serum TPO and PGE2 with the severity and prognosis of patients with liver cirrhosis upper gastrointestinal bleeding

作　　者：胡晓翠 李鹏 汝童 王裕麟 刘庆 HU Xiaocui;LI Peng;RU Tong;WANG Yulin;Liu Qing(Department of Gastroenterology,Beidahuang Group General Hospital,Harbin 150000,China)

机构地区：[1]北大荒集团总医院消化内科,哈尔滨150000 [2]哈尔滨二四二医院肾内科,150066 [3]哈尔滨医科大学附属第一医院消化内科,150000

出　　处：《传染病信息》2024年第6期487-491,共5页Infectious Disease Information

基　　金：黑龙江卫生计生委科研课题项目(2020-089)。

摘　　要：目的探讨肝硬化上消化道出血(upper gastrointestinal bleeding,UGB)患者血清血小板生成素(thrombopoietin,TPO)、前列腺素E2(prostaglandin E2,PGE2)水平与病情严重程度和预后的关系。方法选取北大荒集团总医院消化内科2020年4月至2023年4月收治的103例肝硬化UGB患者为研究对象。采用酶联免疫吸附测定法测定患者血清TPO、PGE2水平;影响肝硬化UGB预后的因素采用Logistic回归分析;绘制受试者工作特征曲线分析血清TPO、PGE2对肝硬化UGB患者预后的预测价值。结果轻度、中度、重度肝硬化UGB患者血清TPO、PGE2水平依次显著降低(P均<0.05)。相较于存活组,死亡组血清TPO、PGE2水平显著降低(P均<0.05)。死亡组与存活组肝功能Child-Pugh分级有显著差异(P<0.05)。TPO、PGE2水平升高是影响肝硬化UGB患者预后的保护因素,肝功能Child-Pugh分级为C级是影响肝硬化UGB患者预后的危险因素(P均<0.05)。血清TPO、PGE22者联合预测肝硬化UGB患者预后的曲线下面积最高,优于血清TPO、PGE2各自单独预测(P均<0.05)。结论肝硬化UGB患者血清TPO、PGE2水平降低,2者联合可更好的预测肝硬化UGB患者预后,具有较高的预测价值。Objective To explore the relationship between serum thrombopoietin(TPO)and prostaglandin E2(PGE2)levels with the severity and prognosis of upper gastrointestinal bleeding(UGB)in patients with liver cirrhosis.Methods Selecting 103 patients with liver cirrhosis and UGB admitted to the Gastroenterology Department of Beidahuang Group General Hospital from April 2020 to April 2023 as the research subjects.Serum levels of TPO and PGE2 were measured using enzyme-linked immunosorbent assay(ELISA).The factors affecting the prognosis of UGB in liver cirrhosis were analyzed using logistic regression.The predictive value of serum TPO and PGE2 for the prognosis of UGB patients with liver cirrhosis was analyzed by plotting receiver operating characteristic(ROC)curves.Results The levels of serum TPO and PGE2 in UGB patients with mild,moderate,and severe cirrhosis were obviously reduced in sequence(P<0.05).Compared with the survival group,the levels of serum TPO and PGE2 in the death group were obviously reduced(P<0.05).There was a significant difference in the Child-Pugh grading of liver function between the death group and the survival group(P<0.05).The high levels of TPO and PGE2 were protective factors affecting the prognosis of UGB patients with cirrhosis(P<0.05),while the Child-Pugh grade C of liver function was identified as a risk factor affecting the prognosis of these patients(P<0.05).The area under the curve(AUC)for the combined prediction of serum TPO and PGE2 levels for the prognosis of UGB patients with liver cirrhosis was the highest,which was better than the individual prediction of serum TPO and PGE2(P<0.05).Conclusion The levels of serum TPO and PGE2 in patients with liver cirrhosis UGB are reduced,and the combination of these two markers can better predict the prognosis of liver cirrhosis UGB patients,demonstrating high predictive value.

关 键 词：肝硬化上消化道出血 小板生成素 前列腺素E2 预后 

分 类 号：R575.2[医药卫生—消化系统]