江汉大学学报(自然科学版) ›› 2022, Vol. 50 ›› Issue (2): 58-63.doi: 10.16389/j.cnki.cn42-1737/n.2022.02.008

• 医学 • 上一篇    下一篇

ABC 评分在肝硬化食管胃底静脉曲张出血患者预后评价中的应用

张倩倩1,张建军*2   

  1. 1. 江汉大学 医学院,湖北 武汉 430056;2. 湖北省第三人民医院 肝病科,湖北 武汉 430033
  • 发布日期:2022-03-28
  • 通讯作者: 张建军
  • 作者简介:张倩倩(1995— ),女,硕士生,研究方向:消化内科。

Application of ABC Score in Prognostic Evaluation of Patients in Liver Cirrhosis with Esophageal Gastric Varices Bleeding

ZHANG Qianqian1,ZHANG Jianjun*2   

  1. 1. School of Medicine,Jianghan University,Wuhan 430056,Hubei,China;2. Department of Liver Diseases,The Third People′s Hospital of Hubei Province,Wuhan 430033,Hubei,China
  • Published:2022-03-28
  • Contact: ZHANG Jianjun

摘要: 目 的 评估ABC 评分在预测肝硬化患者因消化道出血导致的早期高病死率风险以及再出血风险方面的表现,并将其与Child-Pugh 评分、MELD 评分进行比较。方 法 选取2018年1 月— 2021 年3 月湖北省第三人民医院收治的肝硬化静脉曲张出血住院患者95 例,记录了患者在临床住院后首次的ABC 评分、CTP 评分及MELD 评分。用ROC 曲线下面积比较3 种评分方法对早期高病死率风险以及再出血风险评估方面的表现。结 果 在诊断食管胃底静脉曲张出血患者的30 天死亡预后价值上,ABC 评分(AUC = 0. 917)明显优于CTP 评分(AUC = 0. 817)及MELD 评分(AUC = 0. 768)。并且ABC 评分对预测食管胃底静脉曲张出血患者出现再出血方面有一定的诊断价值,曲线下面积为0. 720。CTP 评分及MELD 评分对静脉曲张出血患者出现再出血方面的预后无明显诊断价值,曲线下面积分别为0. 562、0. 578。结 论 ABC 评分预测肝硬化食管静脉曲张破裂出血患者住院30 天内死亡有较佳的诊断价值,优于CTP 评分与MELD 评分。并且ABC 评分对预测静脉曲张出血患者再出血方面有一定的诊断价值。

关键词: 肝硬化, 食管胃底静脉曲张出血, 死亡, 再出血, ABC 评分, 预后

Abstract: Objective To evaluate the performance of ABC score in predicting early high mortality risk and rebleeding risk caused by gastrointestinal bleeding in patients with liver cirrhosis,and compare it with Child-Pugh score and MELD score. Methods This article selected 95 hospitalized patients with cirrhosis and varicose hemorrhage admitted to the Third People′s Hospital of Hubei Province from January 2018 to March 2021 and recorded the first ABC score,CTP score,and MELD score of the patients after the clinical hospitalization. The area under the ROC curve was used to compare the performance of the three scoring methods on evaluating the early high mortality risk and the risk of rebleeding. Results In terms of the prognostic value of 30-day death in patients with esophageal gastric varices bleeding,the ABC score (AUC = 0. 917) was significantly better than the CTP score (AUC = 0. 817) and MELD score(AUC = 0. 768). And the ABC score had a certain diagnostic value in predicting the occurrence of rebleeding in patients with esophageal gastric varices bleeding,and the area under the curve was 0. 720. CTP score and MELD score had no obvious diagnostic value for the prognosis of varicose vein bleeding patients with rebleeding,and the area under the curve was 0. 562 and 0. 578,respectively. Conclusion ABC score has a better diagnostic value in predicting the death of patients with liver cirrhosis and esophageal variceal bleeding within 30 days of hospitalization,and is better than the CTP score and MELD score. ABC score has a certain diagnostic value in predicting rebleeding in patients with varicose vein bleeding.

Key words: liver cirrhosis, esophageal gastric varices bleeding, death, rebleeding, ABC score, prognosis

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