红细胞分布宽度、国际标准化比值、纤维蛋白原在急性非静脉曲张性上消化道出血内镜干预中评估价值

Evaluation value and clinical significance of RDW,INR and FIB in the necessity of ANVUGIB endoscopic intervention

目的 探讨红细胞分布宽度(RDW)、国际标准化比值(INR)、纤维蛋白原(FIB)在急性非静脉曲张性上消化道出血(ANVUGIB)内镜干预必要性中的评估价值及临床意义。方法 选取2019年1月至2021年3月南阳市第二人民医院收治的132例ANVUGIB患者进行研究。根据是否接受内镜干预分为干预组(n=105)、非干预组(n=27),比较两组基线资料、RDW、INR、FIB、Glasgow-Blatchford评分(GBS),Pearson分析RDW、INR、FIB与GBS评分关系,受试者工作特征曲线(ROC)及ROC下面积(AUC)分析RDW、INR、FIB及联合预测需内镜干预的价值。结果 干预组RDW、INR、GBS评分高于非干预组,差异有统计学意义(t=4.732、4.907、8.662,均P<0.05);干预组FIB低于非干预组,差异有统计学意义(t=7.501,均P<0.05);RDW(r=0.526,P<0.001)、INR(r=0.548,P<0.001)与GBS评分呈正相关,FIB与GBS评分关系呈负相关(r=-0.527,P<0.001);RDW、INR联合FIB预测需内镜干预的AUC为0.926,RDW为0.674,INR为0.752,FIB为0.834;RDW、INR高水平者干预率高于低水平者,FIB高水平者干预率低于低水平者,差异均有统计学意义(χ^(2)=11.863、19.421、5.920,均P<0.05)。结论 RDW、INR、FIB与ANVUGIB内镜干预必要性有关,可作为内镜干预必要性的非侵入、便捷的评估参数,为临床管理、治疗等提供参考。

Objective To explore the evaluation value and clinical significance of red blood cell distribution width(RDW),international normalized ratio(INR),and fibrinogen(FIB)in the necessity of en-doscopic intervention for non-varices upper gastrointestinal bleeding(ANVUGIB).Methods A retrospective study was conducted on 132 patients with ANVUGIB admitted to Nanyang Second Peoples Hospital from Jan-uary 2019 to March 2021.According to whether they received endoscopic intervention,they were divided into the intervention group(n=105)and the non-intervention group(n=27).Baseline data,RDW,INR,FIB,and Glasgow-Blatchford score(GBS)between the two groups were compared.Pearson analysis was used to analyze the relationship between RDW,INR,FIB,and GBS scores,and the value of RDW,INR,FIB.The combined prediction of endoscopic intervention using receiver operating characteristic(ROC)curve and area under ROC(AUC)was performed.Results The scores of RDW,INR and GBS in the intervention group were significantly higher than those in the non-intervention group(t=4.732,4.907,8.662,P<0.05).FIB in the intervention group was lower than that in the non-intervention group,and the difference was statistically significant(t=7.501,P<0.05).RDW(r=0.526,P<0.001)and INR(r=0.548,P<0.001)were positively cor-related with GBS score,while FIB was negatively correlated with GBS score(r=-0.527,P<0.001).The com-bination of RDW,INR,and FIB predicts an AUC of 0.926 requiring endoscopic intervention,RDW had an AUC of 0.674,INR had an AUC of 0.752,and FIB had an AUC of 0.834.The intervention rate of people with high levels of RDW and INR was higher than those with low levels,and the intervention rate of those with high levels of FIB were lower than those with low levels,with statistically significant differences(X^(2)=11.863,19.421,5.920,P<0.05).Conclusion RDW,INR,FIB are related to the necessity of ANVUGIB endoscopic intervention,and can be used as non-invasive and convenient evaluation parameters for the necessi-ty of endoscopic intervention,and providing a reference for clinical management and treatment.