AIMS65评分在肝硬化静脉曲张破裂出血患者中的临床应用

Clinical application of AIMS65 score in patients with cirrhotic variceal hemorrhage

目的分析AIMS65评分在肝硬化静脉曲张破裂出血患者中的临床作用。方法回顾分析肝硬化静脉曲张破裂出血患者270例,计算每个患者AIMS65评分,分为低危组130例和高危组140例,比较2组之间的临床指标差别,并绘制受试者工作曲线(ROC)评价其在预测患者再出血、临床输血、死亡的能力。结果高危组血红蛋白及血浆白蛋白水平低于低危组,INR及AMIS65评分高于低危组,再出血、输血、死亡率均高于低危组,差异均有统计学意义(P<0.05)。AIMS65评分在预测患者死亡、再出血发生率方面优于Glasgow-Blatchford评分(ROC曲线下面积分别为0.757和0.547,0.727和0.602),在输血方面略差于Glasgow-Blatchford评分(ROC曲线下面积分别为0.600和0.678),但两种评分比较差异无统计学意义(P>0.05)。结论 AIMS65评分在预测肝硬化静脉曲张破裂出血患者预后方面具有重要意义,并且操作简便,值得推广使用。

Objective To analyze the clinical role of AIMS65 score in patients with cirrhotic variceal hemorrhage.Methods Retrospectively enrolled 270 patients who were diagnosed with esophageal variceal bleeding due to liver cirrhosis,calculated AIMS65 score for each patient,and divided into low risk group 130 cases and high risk group 140 cases,the clinical indicators compared between the two groups.The receiver working curve(ROC) was drawn to evaluate its ability to predict rebleeding,clinical transfusion and death in patients.Results The levels of hemoglobin and plasma albumin in high risk group were lower than those in low risk group,the INR and AMIS65 scores were higher than those in low risk group,the rebleeding,blood transfusion and mortality were higher than those in low risk group,the difference was statistically significant(P<0.05).The AIMS65 score was superior to the Glasgow-Blatchford score in predicting the incidence of death and rebleeding in patients(the area under the ROC curve was 0.757 and 0.547,0.727 and 0.602).The AIMS65 score was slightly worse than the Glasgow-Blatchford score in the blood transfusion(the area under the ROC curve was 0.600 and 0.678),but the difference between the two scores was not statistically significant(P>0.05).Conclusion The AIMS65 score is of great significance in predicting the prognosis of patients with cirrhotic variceal hemorrhage,and it is easy to use in clinical practice and worth promoting.