AIMS65评分系统对急性上消化道出血预后的评估价值

Significance of AIMS65 risk scoring system in evaluating prognosis of acute upper gastrointestinal bleeding

目的探讨AIMS65评分系统对急性静脉曲张性上消化道出血(acute variceal upper gastrointestinal bleeding,AVUGIB)及急性非静脉曲张性上消化道出血(acute non-variceal upper gastrointestinal bleeding,ANVUGIB)复发率及死亡率的评估价值.方法记录郑州大学第一附属医院2013-10/2016-07收治的339例符合研究标准及资料完整的患者的临床资料,出院后随访30d,并将死亡或出院后30d的疾病转归作为临床研究终点.计算不同患者的AIMS65分值,并计算复发率及死亡率,采用受试者工作特征曲线和曲线下面积(area under curve,AUC)分别预测患者复发率及死亡率的准确度.结果随着AIMS65分值的增加,急性上消化道出血的复发率及死亡率相应升高(P<0.05).AIMS65评分系统评估AVUGIB复发率和死亡率的AUC分别为0.717(95%CI:0.568-0.866,P<0.05),0.857(95%CI:0.747-0.967,P<0.05),而ANVUGIB则为0.768(95%CI:0.652-0.884,P<0.05),0.857(95%CI:0.733-0.981,P<0.05).结论 AIMS65评分系统不仅可以用于ANVUGIB,也可以用于AVUGIB.

AIM To assess the value of AIMS65 risk scoring system for evaluating the risk of rebleeding and mortality with acute variceal upper gastrointestinal bleeding（AVUGIB） and acute non-variceal upper gastrointestinal bleeding（ANVUGIB）.METHODS Clinical data for 339 acute upper gastrointestinal bleeding（AUGIB） patients treated from October2013 to June 2016 at the First Affiliated Hospital of Zhengzhou University who met the inclusion criteria and had complete information were included. Each patient＇s score of AIMS65 was calculated. Patients were followed for 30 d after discharge. Death or the prognosis of disease in 30 d after discharge was considered as the clinical study endpoint. The rates of rebleeding and mortality were calculated. The area under the receiver operating characteristic curve（AUC） of AIMS65 risk scoring system was calculated to verify its efficiency in evaluating rebleeding and mortality.RESULTS With the increase in AIMS65 risk scores, the rates of rebleeding and mortality increased in AUGIB patients. The AUCs of AIMS65 risk scoring system for assessing the rates of rebleeding and mortality in AVUGIB were0.717（95%CI： 0.568-0.866, P 〈0.05） and 0.857（95%CI： 0.747-0.967, P 〈0.05）, respectively.The AUCs of AIMS65 risk scoring system for assessing the rates of rebleeding and mortality in ANVUGIB were 0.768（95%CI： 0.652-0.884, P 〈0.05） and 0.857（95%CI： 0.733-0.981, P 〈0.05）,respectively.CONCLUSION AIMS65 risk scoring system can be used to predict the risk and assess the prognosis of AUGIB, including both ANVUGIB and AVUGIB