血尿素氮/肌酐比值在上、下消化道出血鉴别诊断中的应用

Application of Blood Urea Nitrogen/Creatinine Ratio in the Differentiation and Diagnosis of Upper and Lower Gastrointestinal Bleeding

目的:通过分析消化道出血患者血尿素氮(BUN)/肌酐(Cr)比值的变化,寻找鉴别上、下消化道出血BUN/Cr值的最佳诊断切点。方法:回顾收集玉溪市人民医院2015年1月至2016年12月收治急诊科消化道出血患者。收集入院时检测的各项生命体征、年龄和性别资料。计算患者的BUN/Cr值,并按照出血部位分为上消化道出血组和下消化道出血组,进行BUN/Cr的差异性分析。结果:共收集120例消化道出血患者资料,上消化道出血72例,下消化道出血48例。上消化道出血组的BUN/Cr值高于下消化道出血组(P<0.05)。当BUN/Cr值≥28.50时可认为存在上消化道出血,敏感度为76.1%,特异度为89.2%。结论:BUN/Cr值≥28.50对诊断上消化道出血,有较高的价值;而BUN/Cr值<28.50不能鉴别上、下消化道出血。

Objective:By analyzing the changes of blood urea nitrogen/creatinine(BUN/Cr)ratio in patients with gastrointestinal bleeding,the best diagnostic cutoff point was found to identify the BUN/Cr value of upper and lower gastrointestinal bleeding.Methods:The patients in the emergency department of gastrointestinal bleeding admitted to the People’s Hospital of Yuxi City from January 2015 to December 2016 were reviewed and collected,including information on vital signs,age and gender detected at the time of admission.The BUN/Cr differential analysis was performed by calculating the BUN/Cr value of the patient and dividing the bleeding site into the upper gastrointestinal bleeding group and the lower gastrointestinal bleeding group.Results:A total of 120 patients with gastrointestinal bleeding were enrolled,including 72 cases of upper gastrointestinal bleeding and 48 cases of lower gastrointestinal bleeding.The BUN/Cr value of the upper gastrointestinal bleeding group was higher than that of the lower gastrointestinal bleeding group(P<0.05).When the BUN/Cr value was≥28.5,upper gastrointestinal bleeding was considered,the sensitivity was 76.1%,and the specificity was 89.2%.Conclusion:BUN/Cr value≥28.50 has a higher value for the diagnosis of upper gastrointestinal bleeding;and BUN/Cr value<28.50 cannot identify upper and lower gastrointestinal bleeding.