肝硬化食管胃靜脈曲張出血風險預測中AIMS65評分的應用分析

郭回希

[摘要] 目的 研究肝硬化食管胃靜脈曲張出血風險預測中AIMS65評分的應用效果。方法 研究對象為方便選取2017年1月—2019年6月入院的82例肝硬化食管胃靜脈曲張出血患者，所有患者均選用AIMS65評分與終末期肝病模型進行評估，統計2個月內再出血發生率及病死率，兩種評估方式對肝硬化食管胃靜脈曲張出血患者短期內預后狀況及再出血的預測價值選取受試者工作特征及曲線下面積予以評價。結果 82例肝硬化食管胃靜脈曲張出血患者的再出血率、病死率分別為15.85%（13/82）、12.19%（10/82）。生存組終末期肝病模型評分、AIMS65評分分別為（14.57±5.51）分、（1.31±1.14）分，死亡組終末期肝病模型評分、AIMS65評分分別為（21.03±6.44）分、（2.75±1.09）分;對比生存組，死亡組終末期肝病模型評分（t=3.409，P=0.002）、AIMS65評分（t=4.083，P=0.000）更高。終末期肝病模型評分預測死亡的曲線下面積為0.807，AIMS65評分預測死亡的曲線下面積為0.818，差異無統計學意義（Z=0.133，P=0.887）。非再出血組終末期肝病模型評分、AIMS65評分分別為（14.03±5.94）分、（1.28±1.18）分，再出血組終末期肝病模型評分、AIMS65評分分別為（18.49±7.16）分、（2.51±1.12）分;對比非再出血組，再出血組終末期肝病模型評分（t=2.144，P=0.038）、AIMS65評分（t=3.381，P=0.002）更高。終末期肝病模型評分預測再出血的曲線下面積為0.591，AIMS65評分預測再出血的曲線下面積為0.759，差異有統計學意義（Z=20.51，P=0.038）。結論 肝硬化食管胃靜脈曲張出血患者短期預后及再出血風險預測中AIMS65評分的應用效果顯著。

[關鍵詞] 肝硬化;食管胃靜脈曲張出血;AIMS65評分;終末期肝病模型

[中圖分類號] R575? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2020）07（c）-0026-03

[Abstract] Objective To study the application effect of AIMS65 score in the risk prediction of esophagogastric varices bleeding in liver cirrhosis. Methods The study subjects were 82 patients with cirrhosis and esophagogastric varices bleeding admitted from January 2017 to June 2019. All patients were evaluated using the AIMS65 score and end-stage liver disease model， two evaluation methods were used to convenient selection evaluate the prognostic status and predictive value of rebleeding in patients with hepatic cirrhosis and esophagogastric varices bleeding in short time. Results The rebleeding rate and mortality rate of 82 patients with liver cirrhosis and esophagogastric varices bleeding were 15.85% （13/82） and 12.19% （10/82）， respectively. The end-stage liver disease model score and AIMS65 score of the survival group were （14.57±5.51）points and （1.31±1.14） points respectively， and the end-stage liver disease model score and AIMS65 score of the death group were （21.03±6.44） points and （2.75±1.09） points， respectively; Compared with the survival group， the end-stage liver disease model score （t=3.409， P=0.002） and AIMS65 score （t=4.083， P=0.000） in the death group were higher. The end-stage liver disease model score predicts the area under the curve of death at 0.807， and the AIMS65 score predicts the area under the curve at 0.818. The difference is not statistically significant （Z=0.133， P=0.887）. The end-stage liver disease model score and AIMS65 score of the non-rebleeding group were （14.03±5.94） points and （1.28±1.18） points respectively， and the end-stage liver disease model score and AIMS65 score of the rebleeding group were （18.49±7.16） points and （2.51±1.12） points; compared with the non-rebleeding group， the end-stage liver disease model score （t=2.1439， P= 0.038） and AIMS65 score （t=3.381， P=0.002） were higher in the rebleeding group. The end-stage liver disease model score predicts the area under the curve of rebleeding was 0.591， and the AIMS65 score predicts the area under the curve of rebleeding was 0.759， the difference is statistically significant （Z=5.051， P=0.038）. Conclusion The application of AIMS65 score in short-term prognosis and risk prediction of rebleeding in patients with cirrhosis and esophagogastric varices bleeding is significant.