摘要
目的探讨上消化道出血的影响因素,并分析红细胞分布宽度(RDW)、胃泌素(GAS)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)水平检测对上消化道出血的诊断效能。方法选取2019年3月至2020年9月该院274例上消化道出血患者作为研究组,另选取30例同期健康体检者作为对照组。比较两组临床资料、RDW、GAS、GSH-Px、MDA水平,分析RDW、GAS与GSH-Px、MDA水平的相关性,采用Logistic多因素回归分析上消化道出血的影响因素,采用受试者工作特征曲线(ROC曲线)评价RDW、GAS、GSH-Px、MDA对上消化道出血的诊断效能。结果研究组性别、年龄、吸烟、饮酒、Child-Pugh分级、脾脏厚度、血清清蛋白、凝血酶原时间与对照组比较,差异均有统计学意义(P<0.05);研究组RDW、GAS、MDA水平均高于对照组,GSH-Px水平低于对照组,差异均有统计学意义(P<0.05);上消化道出血患者RDW、GAS与GSH-Px水平呈负相关,与MDA水平呈正相关(P<0.05);性别、年龄、吸烟、饮酒、Child-Pugh分级、脾脏厚度、血清清蛋白、凝血酶原时间、RDW、GAS、GSH-Px、MDA均为上消化道出血的影响因素(P<0.05);RDW、GAS、GSH-Px、MDA联合检测诊断上消化道出血的曲线下面积(AUC)为0.879,大于各项指标单独诊断的AUC(0.714、0.767、0.764、0.821),4项指标联合检测诊断的灵敏度、特异度分别为81.39%、80.00%;死亡患者RDW、GAS、MDA水平均高于生存患者,GSH-Px水平低于生存患者,差异均有统计学意义(P<0.05)。结论上消化道出血患者RDW、GAS、MDA水平均明显升高,GSH-Px水平降低,各项指标变化与上消化道出血的发生明显相关,早期检测各项指标水平可辅助诊断上消化道出血。
Objective To explore the influencing factors of upper gastrointestinal bleeding,and analyze the diagnostic efficacy of red blood cell distribution width(RDW),gastrin(GAS),glutathione peroxidase(GSH-Px)and malondialdehyde(MDA)in upper gastrointestinal bleeding.Methods A total of 274 patients with upper gastrointestinal bleeding in the hospital from March 2019 to September 2020 were selected as the research group,and 30 patients with healthy physical examination during the same period were selected as the control group.The clinical data,RDW,GAS,GSH-Px and MDA levels of the two groups were compared,and the correlation between RDW,GAS and GSH-Px,MDA levels was analyzed.Logistic multivariate regression was used to analyze the influencing factors of upper gastrointestinal bleeding,and receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic efficacy of RDW,GAS,GSH-Px,and MDA on upper gastrointestinal bleeding.Results The gender,age,smoking,drinking,Child-Pugh grade,spleen thickness,serum albumin,prothrombin time in research group were compared with control group,and the differences were statistically significant(P<0.05).The RDW,GAS,and MDA levels in research group were higher than those in control group,and the GSH-Px level was lower than that in control group,and the differences were statistically significant(P<0.05).RDW and GAS were negatively correlated with GSH-Px level,and positively correlated with MDA level in patients with upper gastrointestinal bleeding(P<0.05).Gender,age,smoking,drinking,Child-Pugh grade,spleen thickness,serum albumin,prothrombin time,RDW,GAS,GSH-Px and MDA were influencing factors for upper gastrointestinal bleeding(P<0.05).The area under the curve(AUC)of the combined detection of RDW,GAS,GSH-Px,and MDA for the diagnosis of upper gastrointestinal bleeding was 0.879,which was greater than the AUC(0.714,0.767,0.764,0.821)of each indicator alone,and the sensitivity and specificity of 4 indicators combined detection to diagnose were 81.39%and 80.00%respectively.The RDW,GAS,and MDA levels in dead patients were higher than those in surviving patients,and the GSH-Px level was lower than that in surviving patients,and the differences were statistically significant(P<0.05).Conclusion In patients with upper gastrointestinal bleeding,the levels of RDW,GAS,and MDA are significantly increased,and the level of GSH-Px is reduced.Changes of various indicators are significantly related to the occurrence of upper gastrointestinal bleeding.Early detection of the levels of various indicators could assist diagnosis of upper gastrointestinal bleeding.
作者
孙喜斌
张玉虹
左路广
贾倩
连晶晶
冯博
高咏梅
张斌
SUN Xibin;ZHANG Yuhong;ZUO Luguang;JIA Qian;LIAN Jingjing;FENG Bo;GAO Yongmei;ZHANG Bin(Department of Clinical Laboratory,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《国际检验医学杂志》
CAS
2021年第23期2900-2904,2909,共6页
International Journal of Laboratory Medicine
关键词
上消化道出血
红细胞分布宽度
胃泌素
谷胱甘肽过氧化物酶
丙二醛
诊断效能
upper gastrointestinal bleeding
red blood cell distribution width
gastrin
glutathione peroxidase
malondialdehyde
diagnostic efficacy
