格拉斯哥-布拉奇福德出血评分对肝硬化食管胃底静脉曲张破裂出血患者预后的预测价值

Prognostic value of the Glasgow Latchford score in patients with liver cirrhosis and esophagogastric variceal bleeding

目的 探讨格拉斯哥-布拉奇福德出血评分(Glasgow-Blatchford,GBS)在肝硬化食管胃底静脉曲张破裂出血(esophageal and gastric variceal bleeding,EGVB)患者预后的预测价值。方法 选取2020年1月至2021年12月丰县人民医院收治的62例肝硬化EGVB患者作为研究对象,按照患者住院期间预后情况分为存活组(n=55)与死亡组(n=7)。比较两组患者白细胞计数、中性粒细胞计数、血小板计数、血红蛋白和GBS评分变化;采用受试者工作特征曲线分析GBS评分对预后的预测价值;采用多因素logistic回归分析影响肝硬化EGVB患者预后的危险因素。结果 死亡组白细胞计数、中性粒细胞计数、血小板计数和GBS评分高于存活组,血红蛋白水平低于存活组,差异有统计学意义(P<0.05)。受试者工作特征曲线分析结果显示,GBS评分在肝硬化EGVB患者预后预测价值中灵敏度为84.23%,特异度为70.56%。多因素logistic回归分析结果显示,年龄大、有饮酒史、白细胞计数升高、中性粒细胞计数升高、血小板计数升高、血红蛋白下降和GBS评分升高均为影响肝硬化EGVB患者预后的独立危险因素。结论 GBS评分在肝硬化EGVB患者治疗预后中具有良好的预测价值,预后越差患者GBS评分越高,且GBS评分为影响患者预后的独立危险因素。

Objective To study the prognostic value of the Glasgow Latchford score(GBS)in patients with cirrhosis and esophagogastric variceal bleeding(EGVB).Methods Sixty-two patients with liver cirrhosis and EGVB who were treated at Fengxian People's Hospital between January 2020 and December 2021 were selected as study subjects and divided into survival(n=55)and death groups(n=7)based on the prognosis of patients during hospitalization.The white blood cell count(WBC),neutrophil(NEUT)count,platelet count,hemoglobin concentration,and GBSs were compared between the two groups.The prognostic value of the GBS was analyzed based on the receiver operating characteristic(ROC)curve.The prognostic risk factors for EGVB patients with liver cirrhosis were analyzed using univariate and multivariate analyses.Results The WBC,NEUT,and platelet counts in the death group were higher than the survival group.The hemoglobin concentration in the death group was lower than the survival group(P<0.05).The GBS in the death group was higher than the survival group(P<0.05).ROC curve analysis showed that the sensitivity and specificity of the GBS in predicting the prognosis of EGVB patients with cirrhosis was 84.23%and 70.56%,respectively.Multivariate logistic regression analysis showed that age,a history of consuming alcohol,elevated WBC,NEUT,and platelet counts,decreased hemoglobin concentration,and an increased GBS were independent risk factors affecting the prognosis of patients with EGVB cirrhosis.Conclusions The GBS has good predictive value in the prognosis of patients with liver cirrhosis and EGVB.The worse the prognosis,the higher the GBS;thus,the GBS score is an independent risk factor affecting the prognosis of patients with cirrhosis and EGVB.