摘要
目的：探讨△MELD对食管胃底静脉曲张破裂出血患者短期预后的预测价值。方法选择本院2011年1月～2013年12月发生食管胃底静脉曲张破裂出血的56例患者为研究对象，根据患者的临床资料建立CTP评分、MELD评分、△MELD评分3种方式，比较3种评分对预测患者短期预后的准确性。结果56例患者在住院及随访期间死亡21例，死亡率为37.5%。两组1、3、6个月的CTP评分、MELD评分比较差异有统计学意义（P〈0.01）；两组3、6个月的△MELD评分比较差异有统计学意义（P〈0.01）。3个月ROC曲线下面积由大到小依次为△MELD（0.88±0.18），MELD（0.85±0.07），CTP（0.76±0.11）；6个月ROC曲线下面积由大到小依次为△MELD（0.95±0.04），MELD（0.85±0.21），CTP（0.61±0.09）。结论△MELD指标是评估食管胃底静脉曲张破裂出血患者短期预后的良好指标，其准确性优于MELD评分和CTP评分，值得临床深入研究。
Objective To explore predictive value of △MELD evaluate short-term prognosis of esophageal-gastric fundus variceal bleeding. Methods 56 cases of patients with esophageal-gastric fundus variceal bleeding in our hospital from January 2011 to December 2013 were selected as research objects.Three scoring manners （CTP score,MELD score and△MELD score）were set up according to clinical dates of patients.Three scoring manners to predict short-term prognosis of patients with accuracy was compared. Results In 56 patients,21 patients were dead during hospitalization or follow-up visit,and the mortality was 37.5%.The CTP score,MELD score at 1,3,6-month in two groups was compared respectively,with statistical difference （P〈0.01）.△MELD score at 3,6-month in two groups was compared respectively, with statistical difference（P〈0.01）.The area under the ROC curve at 3 months from big to little was△MELD（0.88±0.18）, MELD（0.85±0.07）,CTP（0.76±0.11）respectively.The area under the ROC curve at 6 months from big to little was△MELD （0.95±0.04）,MELD （0.85±0.21）,CTP （0.61±0.09）respectively. Conclusion The△MELD is good indicator to evaluate the short-term prognosis for patients with esophageal-gastric fundus variceal bleeding.Its accuracy is better than that of MELD score and CTP score.It is worthy of further clinical research.
出处
《中国当代医药》
2014年第28期37-39,共3页
China Modern Medicine
基金
江西省卫生厅科技计划课题(20133092)
关键词
食管胃底静脉曲张出血
预后评估
临床价值
Esophageal-gastric fundus variceal bleeding
Prognostic evaluation
Clinical value
