血清D-二聚体、前列腺素E2联合Glasgow-Blatchford评分对急性上消化道出血患者预后的预测价值分析  

Prognostic value of serum D-dimer and prostaglandin E2 combined with Glasgow Blatchford score in patients with acute upper gastrointestinal bleeding

作　　者：石晓旭 吴涛 李立伟 Shi Xiao-xus;Wu Tao;Li Li-wei(Department of Emergency,Hebi People's Hospital,Hebi 458030,Henan,China;Department of General Surgery,Hebi People's Hospital,Hebi 458030,Henan,China)

机构地区：[1]鹤壁市人民医院急诊科,河南鹤壁458030 [2]鹤壁市人民医院普外科,河南鹤壁458030

出　　处：《四川生理科学杂志》2025年第1期159-162,共4页

摘　　要：目的:分析血清D-二聚体(D-dimer,D-D)、前列腺素E2(Prostaglandin E2,PGE-2)联合格拉斯哥-布拉奇福德(Glasgow-Blatchford,GBS)评分预测急性上消化道出血(Acute Upper Gastrointestinal Bleeding,AUGIB)的临床价值。方法:选取2021.3-2024.1期间本院收治的112例AUGIB患者作为研究对象。根据AUGIB患者首次发生出血事件后30 d是否出现死亡,将患者分为死亡组和存活组。检测患者血清D-D和PGE-2水平,并计算GBS。采用多因素logistic回归模型识别AUGIB患者30 d死亡的独立预测因素,应用受试者工作特征ROC曲线分析血清D-D、PGE-2、GBS分数对AUGIB患者预后的诊断效能。结果:112例患者中30 d后死亡23例(20.53%),存活89(79.46%)例。死亡组血清D-D、出血次数显著高于存活组,PGE-2、GBS分数显著低于存活组(P<0.05)。血清D-D、PGE-2、出血次数、GBS分数均为AUGIB患者死亡的独立影响因素。血清D-D、PGE-2、GBS分数以及三者联合预测AUGIB患者预后的ROC曲线下面积分别为0.758、0.786、0.777、0.851,差异均有统计学意义(P<0.05)。结论:血清D-D、PGE-2、GBS分数均为影响AUGIB患者预后的危险因素,且三者联合分析在预测AUGIB患者的预后方面显示出较高的临床价值。Objective:The clinical value of Serum D-dimer(D-Dimer)analysis D-D),Prostaglandin E2(PGE-2)combined with Glasgow-Blatchford(GBS)score in predicting Acute Upper Gastrointestinal Bleeding(AUGIB).Methods:112 AUGIB patients admitted to our hospital during 2021.3 to 2024.1 were selected as the study objects.Patients with AUGIB were divided into death and survival groups based on whether death occurred 30 days after the first bleeding event.Serum D-D and PGE-2 levels were detected and GBS was calculated.Multivariate logistic regression model was used to identify independent predictors of 30d death in AUGIB patients,and receiver operating characteristic ROC curve was used to analyze the diagnostic efficacy of serum D-D,PGE-2 and GBS scores on the prognosis of AUGIB patients.Results:Of the 112 patients,23(20.53%)died after 30 days,and 89(79.46%)survived.Serum D-D and bleeding times in death group were significantly higher than those in survival group,PGE-2 and GBS scores were significantly lower than those in survival group(P<0.05).Serum D-D,PGE-2,bleeding times and GBS score were independent factors of death in AUGIB patients.The area under ROC curve of serum D-D,PGE-2,GBS score and their combination to predict the prognosis of AUGIB patients were 0.758,0.786,0.777,and 0.851,respectively,with statistical significance(P<0.05).Conclusion:Serum D-D,PGE-2 and GBS scores are all risk factors affecting the prognosis of patients with AUGIB,and the combined analysis of these three factors shows high clinical value in predicting the prognosis of patients with AUGIB.

关 键 词：血清D-二聚体 前列腺素E2 Glasgow-Blatchford评分 急性上消化道出血 

分 类 号：R573.2[医药卫生—消化系统]