天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (2): 182-186.doi: 10.11958/20170885

• 临床研究 • 上一篇    下一篇

Glasgow-Blatchford评分与全Rockall评分系统预测上消化道出血临床结局的对比研究

薛挺1 ， 胡锋2△   

  1. 1 陕西省宝鸡市中心医院消化内科 （邮编721000）； 2 陕西省商洛市中心医院消化内科
  • 收稿日期:2017-08-11 修回日期:2017-12-15 出版日期:2018-02-15 发布日期:2018-02-15
  • 通讯作者: 薛挺 E-mail:xueting198303@163.com

Comparative study on Glasgow-Blatchford score and full Rockall score system in predicting clinical outcomes of upper gastrointestinal bleeding

XUE Ting1 , HU Feng2△   

  1. 1 Department of Gastroenterology, Baoji Central Hospital, Shaanxi 721000, China; 2 Department of Gastroenterology, Shangluo Central Hospital
  • Received:2017-08-11 Revised:2017-12-15 Published:2018-02-15 Online:2018-02-15

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摘要： 摘要： 目的 比较 Glasgow-Blatchford 评分 （GBS） 与全 Rockall 评分 （全 RS） 系统对上消化道出血 （UGIB） 患者临床结局的预测价值。方法 选取 2014 年 3 月—2016 年 6 月收治的 UGIB 患者 400 例。采用 GBS 评分和全 RS 评分系统对 UGIB 患者进行评估。应用受试者工作特征 （ROC） 曲线比较两个系统对患者 1 个月死亡、 输血、 再出血、 重症监护病房 （ICU） 住院、 内镜干预的预测价值。结果 38 例患者失访， 362 例患者 1 个月病死率、 再出血率、 输血率、 ICU 住院率和内镜干预率分别为 11.6%、 9.4%、 17.7%、 13.3% 和 16.0%。GBS 对 ICU 住院 （AUC=0.731， P=0.009）、 再出血 （AUC=0.707， P=0.019）、 输血 （AUC=0.704， P=0.021）、 内镜干预 （AUC=0.742， P=0.006） 有预测价值。全 RS 预测患者 1 个月死亡有预测价值 （AUC=0.681， P=0.040）。GBS 和全 RS 预测临床结局的 ROC 曲线比较差异均有统计学意义 （P＜0.05）。结论 GBS 预测 UGIB 患者 ICU 住院、 再出血、 输血及内镜干预的临床结局较好； 全 RS 系统预测 UGIB 患者 1个月死亡情况优于 GBS。

关键词: 关键词： 胃肠出血, ROC 曲线, 全Rockall 评分, Glasgow-Blatchford 评分, 上消化道出血, 临床结局

Abstract: Abstract: Objective To compare Glasgow-Blatchford score (GBS) with full Rockall score system (full RS) in predicting clinical outcomes of upper gastrointestinal bleeding (UGIB). Methods Four hundred hospitalized UGIB patients were enrolled in this study in Baoji Central Hospital from March 2014 to June 2016. Patients were scored by full RS and GBS, respectively. The receiver operating characteristic (ROC) curve analysis was used to compare the predictive values of the two score systems for mortality, re-bleeding, transfusion, ICU admission and endoscopic intervention. Results Thirty- eight cases were lost in follow-up. The one-month mortality rate, re-bleeding rate, blood transfusion rate, ICU admission rate and endoscopic intervention rate of 362 patients were 11.6%, 9.4%, 17.7%, 13.3% and 16.0%, respectively. GBS showed better predictive values in ICU admission (AUC=0.731, P=0.009), re-bleeding (AUC=0.707, P=0.019), blood transfusion (AUC=0.704, P=0.021) and endoscopic intervention (AUC=0.742, P=0.006). Full RS showed better predictive values in one-month mortality (AUC=0.681, P=0.040). There was significant difference in predicting value of clinical outcomes of UGIB by ROC curve between GBS and full-RS systems (P＜0.05). Conclusion The GBS system is more suitable for predicting clinical outcomes of ICU admission, re-bleeding, blood transfusion and endoscopic intervention in patients of UGIB. The full-RS system is more suitable for predicting one-month mortality of UGIB patients.

Key words: Key words: gastrointestinal hemorrhage, ROC curve, full Rockall score, Glasgow-Blatchford score, upper gastrointestinal bleeding, clinical outcome