多种评分系统在肝硬化合并食管胃底静脉曲张出血预后评估中的价值

目的 比较AIMS65、GBS、MGBS、EGBS、CRS、CANUKA、Child-Turcotte-Pugh(CTP)、MELD、MELD-Na评分系统在肝硬化合并食管胃底静脉曲张破裂出血患者（esophagealgastricvariceal bleeding,EGVB）预后评估中的价值,探讨影响肝硬化合并EGVB患者预后不良的影响因素。方法 对确诊为肝硬化合并EGVB的患者169例,根据患者是否发生院内再出血或死亡将患者分为预后良好组和预后不良组,计算出每名患者入院时的各模型评分,比较2组患者的临床特点。结果 预后不良组35例,预后良好组134例,预后不良组的评分均高于预后良好组,AIMS65评分在预测患者是否预后不良时表现最优,且差异具有统计学意义（P <0.05）。预后良好组患者HB、ALB较预后不良组高,PT、INR较预后不良组低,差异具有统计学意义（P <0.05）,经多因素Logistic回归分析提示ALB可能是肝硬化合并EGVB患者预后不良的独立保护因素。结论 AIMS65是肝硬化合并食管胃底静脉曲张出血患者预后评估的最佳评分系统;ALB可能是肝硬化合并...

Value of Multiple Scoring Systems in Evaluating the Prognosis of Liver Cirrhosis Complicated with Esophageal and Gastric Varices Bleeding

  Objective  To compare the values of AIMS65, GBS, MGBS, EGBS, CRS, CANUKA, Child-Turcotte-Pugh （CTP）, MELD, and MELD-Na scoring systems in the evaluation of the prognosis of patients with liver cirrhosis and EGVB, and explore the factors affecting the poor prognosis of patients with liver cirrhosis and EGVB.   Methods  A total of 169 patients diagnosed with liver cirrhosis and EGVB were divided into a good prognosis group and a poor prognosis group according to whether the patients had rebleeding or death in the hospital. The scores of each model at the time of admission of each patient were calculated, and the clinical characteristics of the two groups of patients were compared.   Results  There were 35 cases in the poor prognosis group and 134 cases in the good prognosis group. The scores of the poor prognosis group were higher than those of the good prognosis group. The AIMS65 score was the best in predicting whether the patient had a poor prognosis, and the difference was statistically significant （P < 0.05）. The HB and ALB in the good prognosis group were higher than those in the poor prognosis group, and the PT and INR were lower than those in the poor prognosis group. The difference was statistically significant （P < 0.05）. Multivariate logistic regression analysis suggested that ALB may be an independent protection factor for poor prognosis in patients with liver cirrhosis and EDVB.   Conclusion  AIMS65 is the best scoring system for prognostic evaluation of patients with liver cirrhosis and esophageal varices bleeding; ALB may be an independent protective factor for the poor prognosis of patients with liver cirrhosis and esophageal and gastric varices bleeding.