摘要
目的评估血小板-白蛋白-胆红素评分(PALBI)对肝硬化合并急性上消化道出血患者30 d内死亡的预测价值。方法回顾性收集2016年1月—2020年2月在复旦大学附属金山医院因急性上消化道出血入院的211例肝硬化患者,根据30 d内生存情况分为死亡组(n=24)和生存组(n=187),收集患者的流行病学资料(年龄、性别等)和实验室检查资料(血常规、肝肾功能、凝血功能等),计算入院时的PALBI、ALBI、CTP和MELD评分,比较两组间评分是否存在差异。计量资料两组间比较采用t检验;计数资料两组间比较采用χ^(2)检验。通过受试者工作特征曲线(ROC曲线)及曲线下面积(AUC)衡量模型的预测能力。AUC的比较采用DeLong检验。结果死亡组PALBI、ALBI、CTP和MELD评分分别为-1.47±0.35、-0.74±0.49、10.25±1.98、17.25±4.68,生存组PALBI、ALBI、CTP和MELD分值分别为-1.94±0.36、-1.38±0.51、8.06±1.70、11.63±4.83,死亡组各项评分均明显高于生存组(P值均<0.001)。PALBI、ALBI、CTP和MELD评分的ROC曲线下面积分别为0.827、0.824、0.790、0.811,AUC两两比较差异均无统计学意义(P值均>0.05)。结论PALBI评分对肝硬化合并急性上消化道出血30 d内死亡的预测表现良好,与CTP和MELD评分相当。
Objective To investigate the value of platelet-albumin-bilirubin score(PALBI)in predicting the 30-day mortality of patients with liver cirrhosis and acute upper gastrointestinal bleeding(AUGIB).Methods A retrospective analysis was performed for the clinical data of 211 patients with liver cirrhosis who were admitted to Jinshan Hospital of Fudan University due to AUGIB from January 2016 to February 2020,and according to the survival status within 30 days,they were divided into death group with 24 patients and survival group with 187 patients.Epidemiological data(including age and sex)and laboratory examination results(including routine blood test results,hepatic and renal function,and coagulation function)were collected,and the scores of PALBI,albumin-bilirubin(ALBI),Child-Turcotte-Pugh(CTP),and Model for End-Stage Liver Disease(MELD)on admission were calculated and compared between the two groups.The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.With the application of 95%confidence interval,the receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC)were used to evaluate the predictive ability of the model.The DeLong test was used for comparison of ROC curve.Results Compared with the survival group,the death group had significantly higher PALBI score(-1.47±0.35 vs-1.94±0.36,P<0.001),ALBI score(-0.74±0.49 vs-1.38±0.51,P<0.001),CTP score(10.25±1.98 vs 8.06±1.70,P<0.001),and MELD score(17.25±4.68 vs 11.63±4.83,P<0.001).PALBI,ALBI,CTP,and MELD scores had an AUC of 0.827,0.824,0.790,and 0.811,respectively,and there was no significant difference in AUC between any two scores(P>0.05).Conclusion PALBI score has good performance in predicting the 30-day mortality of patients with liver cirrhosis and AUGIB and is comparable to CTP and MELD scores.
作者
徐陈
蒋淼
XU Chen;JIANG Miao(Department of Gastroenterology,Jinshan Hospital of Fudan University,Shanghai 201508,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2021年第7期1578-1581,共4页
Journal of Clinical Hepatology
关键词
肝硬化
出血
PALBI评分
预后
Liver Cirrhosis
Hemorrhage
Platelet-albumin-bilirubin Score
Prognosis
