AIMS65评分对肝硬化食管胃静脉曲张出血风险评估的临床研究

目的 探讨AIMS65评分对肝硬化食管胃静脉曲张破裂出血(EGVB)患者短期预后和再出血的预测价值。方法 采用终末期肝病模型（MELD）和AIMS65评分对110例肝硬化EGVB患者进行评分，统计6周内的再出血和死亡情况，应用受试者工作特征（ROC）曲线下面积（AUC）评价两种评分系统对短期预后和再出血的预测价值。结果 本组患者病死率14.6%，再出血率17.3%。死亡组MELD、AIMS65评分均高于生存组（P＜0.05），MELD、AIMS65评分预测死亡的AUC分别为0.813、0.825，但差异无统计学意义（P＞0.05）。再出血组MELD、AIMS65评分均高于非再出血组（P＜0.05），MELD、AIMS65评分预测再出血的AUC分别为0.599、0.767，差异有统计学意义（P＜0.05）。结论 AIMS65评分过程简单快捷，对肝硬化EGVB短期预后和再出血有较好的预测价值。

Clinical study of AIMS65 score for risk assessment of esophageal gastric variceal bleeding in liver cirrhosis

Objective To evaluate the clinical value of AIMS65 score system in the prediction of short term prognosis and rebleeding of esophageal gastric variceal bleeding(EGVB) in liver cirrhosis. Methods A total of 110 patients with EGVB were graded with Model of End stage Liver Disease(MELD) and AIMS65 score. Six weeks' mortality and rebleeding of the patients were observed. The accuracy of the two scores on predicting short term prognosis and rebleeding were analyzed using the area under the receiver operating characteristic (ROC) curve (AUC). Results The six weeks' mortality and rebleeding rate were 14.6% and 17.3% in the patients, respectively. MELD and AIMS65 score for deaths were higher than those for survivors significantly(P＜0.05).The AUC of MELD and AIMS65 score for predicting 3 month mortality were 0.813 and 0.825, respectively, but no significant difference was found between the two scores(P＞0.05). MELD and AIMS65 score in patients with rebleeding were higher than those with non rebleeding significantly(P＜0.05). The AUC of MELD and AIMS65 score for predicting rebleeding were 0.599 and 0.767 with stastistical significance(P＜0.05).Conclusion AIMS65 score is useful for prediction of short term prognosis and rebleeding of EGVB in liver cirrhosis. It is a simple, rapid and convenient method.