临床肝胆病杂志2024，Vol.40Issue(3)：521-526,6.DOI:10.12449/JCH240314
基于APRI和PALBI构建的列线图对肝硬化并发食管胃底静脉曲张破裂出血的预测价值
Establishment of a nomogram model for predicting liver cirrhosis with esophagogastric variceal bleeding based on aspartate aminotransferase-to-platelet ratio index and platelet-albumin-bilirubin score
摘要
Abstract
Objective To investigate the value of aspartate aminotransferase-to-platelet ratio index(APRI)and platelet-albumin-bilirubin(PALBI)score in predicting the risk of esophagogastric variceal bleeding in patients with liver cirrhosis.Methods A total of 119 patients with liver cirrhosis who were admitted to The First Affiliated Hospital of Soochow University from May 2021 and June 2022 were enrolled,and clinical data,routine blood test results,serum biochemistry,and coagulation test results were collected from all patients.According to the presence or absence of esophagogastric variceal bleeding,the patients were divided into non-bleeding group with 59 patients and bleeding group with 60 patients,and a comparative analysis was performed for the two groups.The independent samples t-test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-squared test or the Fisher's exact test was used for comparison of categorical data between groups.The multivariate Logistic regression analysis was used to identify the independent risk factors for esophagogastric variceal bleeding in patients with liver cirrhosis and establish a nomogram predictive model.Results The male patients accounted for 75.00%in the bleeding group and 40.68%in the non-bleeding group,and there was a significant difference in sex composition between the two groups(χ2=14.384,P<0.001).Chronic hepatitis B was the main etiology in both the bleeding group and the non-bleeding group(53.33%vs 38.98%),and there was no significant difference in composition ratio between the two groups(χ2=2.464,P=0.116).Compared with the non-bleeding group,the bleeding group had a significantly higher activity of AT-IIIA(t=3.329,P=0.001)and significantly lower levels of PLT,TBil,Ca,TC,and TT(all P<0.05).There were significant differences in APRI and PALBI between the two groups(χ2=6.175 and 19.532,both P<0.05).The binary logistic regression analysis showed that APRI(odds ratio[OR]=0.309,95%confidence interval[CI]:0.109—0.881,P=0.028),PALBI(OR=7.667,95%CI:2.005—29.327,P=0.003),Ca(OR=0.001,95%CI:0.000—0.141,P=0.007),TC(OR=0.469,95%CI:0.226—0.973,P=0.042),and TT(OR=0.599,95%CI:0.433—0.830,P=0.002)were independent influencing factors for esophagogastric variceal bleeding in liver cirrhosis.A nomogram model was established based on the above factors and had an index of concordance of 0.899 and a well-fitted calibration curve.Conclusion APRI and PALBI have a good value in predicting esophagogastric variceal bleeding in patients with liver cirrhosis,and the nomogram model established based on this study can predict the incidence rate of esophagogastric variceal bleeding in patients with liver cirrhosis.关键词
肝硬化/食管和胃静脉曲张/胃肠出血/APRI/PALBI/列线图Key words
Liver Cirrhosis/Esophageal and Gastric Varices/Gastrointestinal Hemorrhage/APRI/PALBI/Nomograms引用本文复制引用
李欣忆,李娇娇,李莹莹,魏虹合,熊雨凡,张新驰,孙蔚,陈丽..基于APRI和PALBI构建的列线图对肝硬化并发食管胃底静脉曲张破裂出血的预测价值[J].临床肝胆病杂志,2024,40(3):521-526,6.基金项目
"十三五"国家科技重大专项(2017ZX10203201002-002) （2017ZX10203201002-002）
苏州市卫生青年骨干人才"全国导师制"培训项目(20190013990009) （20190013990009）
天晴肝病研究基金(TQGB20210134) National Major Science and Technology Special Project of the 13th Five-Year Plan Period(2017ZX10203201002-002) （TQGB20210134）
Suzhou Health Youth Backbone Talent"National Tutorial System"Training Project(20190013990009) （20190013990009）
Tianqing Liver Disease Research Foundation(TQGB20210134) （TQGB20210134）
