Urashima M, Toyoda S, Nakano T, Matsuda S, Kobayashi N, Kitajima H, Tokushige A, Horita H, Akatsuka J, Maekawa K
Department of Pediatrics, Tokyo Jikei University School of Medicine, Japan.
J Pediatr Gastroenterol Nutr. 1992 Jul;15(1):89-92. doi: 10.1097/00005176-199207000-00014.
Determining the site and severity of blood loss is important in the management of children with gastrointestinal (GI) bleeding. Blood urea nitrogen (BUN) and serum creatinine (Cr) were measured on the day of hospitalization and the ratio of BUN/Cr was calculated in 11 children with 16 episodes of upper GI bleeding and 49 with lower GI bleeding. There was a significant difference between the two GI bleeding groups with regard to BUN/Cr ratio (p less than 0.001). When the ratio was 30 or above, the specificity of upper GI bleeding was 98% with a sensitivity of 68.8%. A linear relationship was found between the BUN/Cr ratio and delta Hb (delta Hb = 0.08 x BUN/Cr +/- 0.8 g/dl) for bleeding originating from the upper GI tract. This study confirms that measurement of the BUN/Cr ratio is useful for localizing the source of bleeding to the upper GI tract and also demonstrates its usefulness as an estimation of the severity of blood loss from the upper GI tract.
确定失血部位和严重程度对胃肠道（GI）出血儿童的治疗很重要。对11例有16次上消化道出血发作的儿童和49例下消化道出血儿童在住院当天测定了血尿素氮（BUN）和血清肌酐（Cr），并计算了BUN/Cr比值。两组胃肠道出血患儿的BUN/Cr比值有显著差异（p小于0.001）。当比值为30或更高时，上消化道出血的特异性为98%，敏感性为68.8%。发现上消化道出血来源的BUN/Cr比值与血红蛋白变化量（delta Hb = 0.08×BUN/Cr±0.8 g/dl）之间存在线性关系。本研究证实，测定BUN/Cr比值有助于将出血部位定位在上消化道，也证明了其作为估计上消化道失血量严重程度的有用性。
