摘要
目的明确肝硬化食管胃底静脉曲张出血患者合并感染的相关危险因素,为早期病情评估及临床治疗提供指导。方法回顾性分析2014年3月-2019年6月我院收治的482例肝硬化食管胃底静脉曲张出血患者的病历资料,分为感染组和非感染组,采用倾向性评分匹配(PSM)1∶1配对后,感染组78例、非感染组78例,共156例患者纳入研究,比较2组间HGB、TBi L、PT、ALB、WBC、PLT等差异,通过Logistic回归分析感染发生的危险因素,建立预测模型并检验模型拟合度,ROC曲线评价预测模型的诊断价值。结果482例患者中有189例发生感染,感染率为39.21%。2组患者在HGB、TBil、ALB、PT、WBC、PLT、MELD评分、Child-Pugh、腹水、肝性脑病方面差异有统计学意义(P<0.05)。Logistic回归分析显示:腹水、ALB、PT为感染发生的独立危险因素,预测模型ROC曲线下面积为0.856,95%可信区间为0.799~0.913,灵敏度、特异度及总体预测的准确率均在80%以上,且模型拟合效果较好(P=0.248)。结论腹水、ALB、PT为肝硬化食管胃底静脉曲张出血患者合并感染发生的独立危险因素。
Objective To determine the risk factors related to concurrent infection in cirrhosis patients with esophagogastric variceal bleeding so as to provide guidance for early disease assessment and clinical treatment.Methods A retrospective review of the medical records of 482 patients with cirrhotic esophagogastric varices bleeding from Mar.2014 to Jun.2019 in Yan’an hospital was divided into infected group and non-infected group,used propensity score matching(PSM)for 1∶1 pairing,78 patients in the infected group and 78 patients in the non-infected group,a total of 156 patients were included in the study.The differences in HGB,TBil,PT and ALB were compared between the two groups,and analyzed the risk factors by Logistic regression model.Established a predictive model and tested the model fit degree,ROC curve evaluated the diagnostic value of the predictive model.Results Of the482 patients,189 had an infection with an infection rate of 39.21%.There was statistically significance in the difference of HGB,TBi L,ALB,PT,WBC,PLT,MELD score,Child-Pugh,ascites and hepatic encephalopathy(P<0.05).Logistic regression analysis showed that ascites,ALB and PT were independent risk factors for infection.The area under the ROC curve of the prediction model was 0.856,the 95%confidence interval was 0.799-0.913,and the sensitivity,specificity and overall prediction accuracy rate were all above 80%,and the model fitting effect was better(P=0.248).Conclusions Ascites,ALB and PT are independent risk factors for concurrent infection in cirrhosis patients with esophagogastric variceal bleeding.
作者
黄维康
樊希蕊
秦榕
伍瑞
黄芸
王辉
HUANG Wei-kang;FAN Xi-rui;QIN Rong;WU Rui;HUANG Yun;WANG Hui(Department of Gestroenterology,Yan an Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650051,China)
出处
《云南医药》
2022年第1期1-5,共5页
Medicine and Pharmacy of Yunnan
基金
昆明市卫生健康委员会卫生科研课题项目(2019-03-10-001)
昆明市卫生健康委员会卫生科研课题项目(2020-03-03-111)
昆明市卫生健康委员会卫生科研课题项目(2020-03-03-113)。
作者简介
黄维康(1990~)男,主治医师,在读硕士研究生,从事肝脏疾病临床工作8年;通信作者:王辉,E-mail:weihool@126.com。
