BUN和Cr及其比值对诊断消化道出血的临床意义

Clinical Significance of Blood Urea Nitrogen,Creatinine and Its Ratio in Diagnosis ofGastrointestinal Bleeding

目的:探讨血尿素氮(BUN)和肌酐(C r)及其比值在诊断与治疗以及区分上、下消化道出血的作用。方法:用贝克曼-库尔特CX 3生化分析仪检测BUN和C r,同时得到BUN/C r比值。用SPSS 11.5统计软件把患者数据与健康对照组作统计分析。结果:82例健康体检者,101例上消化道出血患者和55例下消化道出血患者,其均数分别为:BUN 4.73、12.42、7.44;C r 79.17、94.26、90.53;BUN/C r 60.72、138.74、82.67。三组人群的BUN、C r及BUN/C r比值作方差统计分析结果,差异有极显著性(P<0.001);在两两比较中,只有上、下消化道出血两组患者的C r差异无显著性(P>0.05);在逻辑回归分析中,BUN/C r比值>109,确定上消化道出血的敏感性为75.49%,特异性为98.72%。结论:BUN和C r及其比值可作为诊断和治疗消化道出血的生化指标,BUN/C r比值是鉴别上、下消化道出血的重要依据。

Objective：To study the clinical significance of blood urea nitrogen（BUN）,creatinine（Cr） and its ratio in diagnose, treatment and discriminate upper and lower gastrointestinal bleeding. Methods： The data of BUN and Cr were detected with Beckman-Coulter CX3,then calculated its ratio. Above the data was analysed by SPSS 11.5,assumed 82 healthy cases as control. Results ：The means of 82 healthy cases ;101 cases of upper gastrointestinal bleeding;and 55 cases of lower gastrointestinal bleeding respectively were BUN 4. 73, 12.42, 7.44;Cr 79. 17,94.26,90. 53;BUN/Cr 60. 72,138.74,82.67. There were significant difference among BUN, Cr and BUN/Cr of three groups （P〈0. 001）,but, there were no significant difference in Cr between the group of upper gastrointestinal bleeding and lower gastrointestinal bleeding（P〈0. 05）. By logic regression analysis, the ratio of BUN/Cr exceed 109 ,whicih could determine the sensibility of upper gastrointestinal bleeding was 75.49%,specificity was 98.72 %. Conclusion：The BUN,Cr and its ratio can be used as biochemical indicator in diagnose and treatment gastrointestinal bleeding,while BUN/Cr can be used as impor- tant vidence in antidiastole of upper and lower gastrointestinal bleeding.