急性非静脉曲张性上消化道出血患者RDW、D-D、S100A12与病情和临床结局的关系

Relationship between RDW,D-D,S100A12 and the Disease Condition and Clinical Outcome in Patients with Acute Non-Variceal Upper Gastrointestinal Bleeding

目的:探讨急性非静脉曲张性上消化道出血(ANVUGIB)患者红细胞分布宽度(RDW)、D二聚体(D-D)、S100钙结合蛋白12(S100A12)与病情和临床结局的关系。方法:选择2021年7月至2023年8月贵阳市第一人民医院收治的ANVUGIB患者184例作为研究组,同期体检健康者100例作为对照组。根据Rockall危险积分将患者分为低危组(28例)、中危组(60例)、高危组(96例),根据住院期间临床结局将患者分为预后不良组(66例)和预后良好组(118例)。检测RDW、血浆D-D、血清S100A12水平。采用多因素Logistic回归分析ANVUGIB患者临床结局不良的危险因素。结果:研究组RDW、血浆D-D、血清S100A12水平高于对照组(P<0.05)。高危组RDW、血浆D-D、血清S100A12水平显著高于中危组、低危组,中危组RDW、血浆D-D、血清S100A12水平显著高于低危组(P<0.05)。结局不良组患者RDW、血浆D-D、血清S100A12水平高于结局良好组(P<0.05)。多因素Logsitic回归分析显示,Rockall危险积分升高、出血量>1000 m L、RDW升高、血浆D-D升高、血清S100A12升高是ANVUGIB患者临床结局不良的危险因素(P<0.05)。结论:ANVUGIB患者RDW、D-D、S100A12水平与患者病情和临床结局密切相关,RDW升高、血浆D-D升高、血清S100A12升高是ANVUGIB患者临床结局不良的危险因素。

Objective:To investigate the relationship between red blood cell distribution width(RDW),D-dimer(D-D),S100 calcium binding protein 12(S100A12)and disease condition and clinical outcome in patients with acute non-variceal upper gastrointestinal bleeding(ANVUGIB).Methods:184 ANVUGIB patients admitted to The First People's Hospital of Guiyang from July 2021 to August2023 were selected as study group,and 100 healthy individuals who underwent physical examinations during the same period were selected as control group.Patients were divided into low-risk group(28 cases),middle-risk group(60 cases)and high-risk group(96 cases)according to the Rockall risk score,and patients were divided into poor prognosis group(66 cases)and good prognosis group(118 cases)according to the clinical outcome during hospitalization.RDW,plasma D-D and serum S100A12 levels were detected.The risk factors of poor clinical outcomes in ANVUGIB patients were analyzed by multivariate Logistic regression analysis.Results:The levels of RDW,plasma D-D and serum S100A12 in study group were higher than those in control group(P<0.05).The levels of RDW,plasma D-D and serum S100A12 in high-risk group were significantly higher than those in middle-risk group and low-risk group,and the levels of RDW,plasma D-D and serum S100A12 in middle-risk group were significantly higher than those in low-risk group(P<0.05).The levels of RDW,plasma D-D and serum S100A12 in poor outcome group were higher than those in good outcome group(P<0.05).Multivariate Logistic regression analysis showed that,increased Rockall risk score,bleeding volume>1000 m L,increased RDW,increased plasma D-D and increased serum S100A12 were risk factors for poor clinical outcomes in ANVUGIB patients(P<0.05).Conclusion:The levels of RDW,D-D and S100A12 in ANVUGIB patients are closely relate to the patient's disease condition and clinical outcome.Increase RDW,increase plasma D-D and increase serum S100A12 are risk factors for poor clinical outcomes in ANVUGIB patients.