血清表皮生长因子对肝硬化食管胃静脉曲张患者再出血的诊断价值分析  

Analysis of the Diagnostic Value of Serum Epidermal Growth Factor for Rebleeding in Patients with Cirrhotic Esophagogastric Varices

作　　者：陈刚 谷光丽 何映雪 唐尧 CHEN Gang;GU Guangli;HE Yingxue;TANG Yao(Department of Gastroenterology,Liuzhou Workers'Hospital,Liuzhou,Guangxi 545005,China)

机构地区：[1]柳州市工人医院消化内科,广西柳州545005

出　　处：《转化医学杂志》2024年第10期1698-1702,共5页Translational Medicine Journal

基　　金：广西壮族自治区卫生健康委自筹经费科研课题(Z-B20231436)。

摘　　要：目的探讨分析血清表皮生长因子(EGF)对肝硬化食管胃静脉曲张(EGVB)患者再出血的诊断价值。方法选取2023年6月至2024年6月柳州市工人医院收治的120例肝硬化EGVB患者为研究对象,根据有无再出血分为未出血组(n=75)和出血组(n=45)。采用放射免疫分析法检测血清EGF水平。比较2组基础资料、血清学指标及血清EGF差异,采用受试者工作特征(ROC)曲线评估EGF对肝硬化EGVB患者再出血的诊断价值,采用多因素Logistic回归分析肝硬化EGVB患者再出血的相关因素。结果120例EGVB患者中有45例(37.5%)发生再出血。2组静脉曲张程度比较差异有统计学意义,出血组重度静脉曲张比例高于未出血组(P<0.05)。出血组血红蛋白(Hb)、活化部分凝血活酶时间(APTT)、白蛋白(ALB)、胆红素(TBiL)低于未出血组(P<0.05),血小板计数(PLT)高于未出血组(P<0.05);出血组血清EGF水平高于未出血组(P<0.05)。血清EGF诊断EGVB患者再出血的曲线下面积(AUC)为0.812(95%CI:0.752~0.872),敏感度为82.1%,特异度为85.7%。血清EGF高表达[OR:2.42,95%CI:1.36~4.32]为肝硬化EGVB患者再出血的危险因素之一(P<0.05)。结论肝硬化EGVB再出血患者血清EGF水平升高,血清EGF高表达为肝硬化EGVB患者再出血的危险因素,有较高的预测价值。Objective To investigate the diagnostic value of serum epidermal growth factor(EGF)for rebleeding in patients with cirrhotic esophagogastric varices(EGVB).Methods A total of 120 patients with EGVB admitted to Liuzhou Workers'Hospital from June 2023 to June 2024 were selected and divided into the non-bleeding group(75cases)and the bleeding group(45 cases)based on the presence or absence of rebleeding.Serum EGF levels were detected by radioimmunoassay.Differences in basic data,serological indexes,and serum EGF between the two groups were compared.The diagnostic value of EGF for rebleeding in patients with EGVB was evaluated using the receiver operating characteristic(ROC)curve,and related factors of rebleeding in patients with EGVB were analyzed by multivariate Logistic regression.Results Rebleeding occurred in 45(37.5%)of the 120 EGVB patients.There were significant differences in the degree of varicose veins between the two groups,with a higher proportion of severe varicose veins in the bleeding group than in the non-bleeding group(P<0.05).The hemoglobin(Hb),activated partial thromboplastin time(APTT),albumin(ALB),and total bilirubin(TBiL)levels in the bleeding group were lower than those in the non-bleeding group,while the platelet count(PLT)was higher(P<0.05).The serum EGF level in the bleeding group was higher than that in the non-bleeding group(P<0.05).The area under the curve(AUC)of serum EGF for diagnosing rebleeding in patients with EGVB was 0.812(95%CI:0.752-0.872),with a sensitivity of 82.1%and a specificity of 85.7%.High expression of serum EGF[OR:2.42,95%CI:1.36-4.32]was one of the risk factors for rebleeding in patients with EGVB(P<0.05).Conclusion The serum EGF level is elevated in patients with cirrhotic EGVB experiencing rebleeding.High expression of serum EGF is a risk factor for rebleeding in such patients and has a relatively high predictive value.

关 键 词：肝硬化 食管胃静脉曲张 出血 表皮生长因子 ROC曲线 

分 类 号：R657.31[医药卫生—外科学] R446.112.9[医药卫生—临床医学]