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AIMS65评分对肝硬化食管胃静脉曲张出血风险评估的临床研究

  

  1. 南通大学附属南通第三医院  消化内科,江苏 南通  226006
  • 出版日期:2018-06-05 发布日期:2018-06-25
  • 通讯作者: 通信作者:金燕, Email:2496222013@qq.com

Clinical study of AIMS65 score for risk assessment of esophagealgastric variceal bleeding in liver cirrhosis

  1. Department of Gastroenterology,  the Third Hospital affiliated to  Nantong University,   Nantong 226006,  China
  • Online:2018-06-05 Published:2018-06-25
  • Contact: Correspondingauthor: Jin Yan, Email: 2496222013@qq.com

摘要: 目的 探讨AIMS65评分对肝硬化食管胃静脉曲张破裂出血(EGVB)患者短期预后和再出血的预测价值。方法 采用终末期肝病模型(MELD)和AIMS65评分对110例肝硬化EGVB患者进行评分,统计6周内的再出血和死亡情况,应用受试者工作特征(ROC)曲线下面积(AUC)评价两种评分系统对短期预后和再出血的预测价值。结果 本组患者病死率14.6%,再出血率17.3%。死亡组MELD、AIMS65评分均高于生存组(P<0.05),MELD、AIMS65评分预测死亡的AUC分别为0.813、0.825,但差异无统计学意义(P>0.05)。再出血组MELD、AIMS65评分均高于非再出血组(P<0.05),MELD、AIMS65评分预测再出血的AUC分别为0.599、0.767,差异有统计学意义(P<0.05)。结论  AIMS65评分过程简单快捷,对肝硬化EGVB短期预后和再出血有较好的预测价值。

关键词: 肝硬化, 食管和胃静脉曲张, 胃肠出血, 预后

Abstract: Objective  To evaluate the clinical value of AIMS65 score system in the prediction of shortterm prognosis and rebleeding of esophagealgastric variceal bleeding(EGVB) in liver cirrhosis. Methods  A total of 110 patients with EGVB were graded with Model of Endstage Liver Disease(MELD) and AIMS65 score. Sixweeks' mortality and rebleeding of the patients were observed. The accuracy of the two scores on predicting shortterm prognosis and rebleeding were analyzed using the area under the receiver operating characteristic  (ROC) curve  (AUC). Results  The sixweeks' mortality and rebleeding rate were 14.6%  and  17.3% in the patients, respectively. MELD and AIMS65 score for deaths were higher than those for survivors significantly(P<0.05).The AUC of MELD and AIMS65 score for predicting 3month mortality were 0.813 and 0.825, respectively, but no significant difference was found between the two scores(P>0.05). MELD and AIMS65 score in patients with rebleeding were higher than those with nonrebleeding significantly(P<0.05). The AUC of MELD and AIMS65 score for predicting rebleeding were 0.599 and 0.767 with stastistical significance(P<0.05).Conclusion  AIMS65 score is useful for prediction of shortterm prognosis and rebleeding of EGVB in liver cirrhosis. It is a simple, rapid and convenient method.

Key words: liver cirrhosis;esophageal and gastric varices, gastrointestinal hemorrhage;prognosis