肝硬化门静脉高压伴上消化道急性出血患者的血细胞参数、肾功能及营养评分变化及其与预后的相关性  

Changes of blood cell parameters,renal function and nutritional score and their correlation with prognosis in cirrhotic patients with portal hypertension and acute upper gastrointestinal hemorrhage

作　　者：陈镇 余天垒 刘晓超[2] 尹萌 Chen Zhen;Yu Tianlei;Liu Xiaochao;Yin Meng(Department of Gastroenterology,Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710000,China;Department of Gastroenterology,Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]西安交通大学附属红会医院消化内科,710000 [2]汉中市中心医院消化内科,陕西省723000

出　　处：《中华消化病与影像杂志(电子版)》2025年第2期149-154,共6页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：西安市卫生健康委员会卫生科研项目(2024yb23)。

摘　　要：目的探讨肝硬化门静脉高压伴上消化道急性出血患者的血细胞参数、血清前白蛋白(PA)、血尿素氮/肌酐(BUN/Cr)比值、预后营养指数(PNI)、改良危重症营养风险(mNUTRIC)评分变化及其与预后的相关性。方法选择2020年1月至2023年12月西安交通大学附属红会医院和汉中市中心医院接诊的肝硬化门静脉高压伴上消化道急性出血患者120例作为研究组,选择100例肝硬化门静脉高压患者作为对照组。比较两组患者的血细胞参数[红细胞分布宽度(RDW)、血小板(PLT)、血小板压积(PCT)、红细胞压积(HCT)、血小板平均体积(MPV)]、血清PA、BUN/Cr比值、PNI、mNUTRIC评分变化,并比较不同预后患者上述指标的变化。采用Pearson相关分析法分析肝硬化门静脉高压伴上消化道急性出血患者的血细胞参数、PA、BUN/Cr比值、PNI、mNUTRIC评分与预后的相关性。结果研究组患者RDW、MPV、BUN/Cr比值、mNUTRIC评分均高于对照组,RDW、PLT、PCT、HCT、MPV、PA、PNI水平均低于对照组,差异有统计学意义(P<0.05);死亡组患者RDW、MPV、BUN/Cr比值、mNUTRIC评分均高于存活组,RDW、PLT、PCT、HCT、MPV、PA、PNI水平均低于存活组,差异有统计学意义(P<0.05);Pearson相关分析显示,RDW、MPV、BUN/Cr比值、mNUTRIC评分与预后均呈正相关,RDW、PLT、PCT、HCT、MPV、PA、PNI与预后均呈负相关(P<0.05)。结论肝硬化门静脉高压伴上消化道急性出血患者的血细胞参数、PA、BUN/Cr比值、PNI、mNUTRIC评分变化与预后密切相关,监测这些指标有助于提前干预、改善预后。Objective To investigate the changes of blood cell parameters,serum prealbumin(PA),blood urea nitrogen/creatinine(BUN/Cr)ratio,prognostic nutrition index(PNI),modified critical illness nutritional risk(mNUTRIC)score and their correlation with prognosis in cirrhotic patients with portal hypertension and acute upper gastrointestinal hemorrhage.Methods A total of 120 patients with cirrhotic portal hypertension accompanied with upper gastrointestinal acute hemorrhage admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University and Hanzhong Central Hospital from January 2020 to December 2023 were selected as study group,and 100 patients with cirrhotic portal hypertension were selected as control group.Blood cell parameters erythrocyte distribution width(RDW),platelet(PLT),platelet volume(PCT),hematocrit(HCT),mean platelet volume(MPV),serum PA,BUN/Cr ratio,PNI and mNUTRIC score were compared between the two groups,and the changes of the above indexes in patients with different prognosis were compared.The correlations between blood cell parameters,serum PA,BUN/Cr ratio,PNI,mNUTRIC score and prognosis in cirrhotic patients with portal hypertension and acute upper gastrointestinal hemorrhage were analyzed by Pearson correlation analysis.Results RDW,MPV,BUN/Cr ratio and mNUTRIC score in study group were higher than those in control group,while RDW,PLT,PCT,HCT,MPV,serum PA and PNI levels were lower than those in control group,with statistically significant differences(P<0.05);RDW,MPV,BUN/Cr ratio and mNUTRIC score in death group were higher than those in survival group,while RDW,PLT,PCT,HCT,MPV,serum PA and PNI levels were lower than those in survival group,with statistically significant differences(P<0.05);the results of Pearson correlation analysis showed that RDW,MPV,BUN/Cr ratio and mNUTRIC score were positively correlated with prognosis,while RDW,PLT,PCT,HCT,MPV,serum PA and PNI were negatively correlated with prognosis(P<0.05).Conclusion The changes of blood cell parameters,serum PA,BUN/Cr ratio,PNI and mNUTRI

关 键 词：肝硬化 门静脉高压 上消化道出血 前白蛋白 血尿素氮 肌酐 营养风险 预后 

分 类 号：R575.2[医药卫生—消化系统]