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肝硬化患者的上消化道出血。多维度分析对与出血原因相关变量研究的贡献。

Upper digestive tract hemorrhage in cirrhotic patients. Contribution of multidimensional analysis to the study of variables related to the cause of the hemorrhage.

作者信息

Poynard T, Chaput J C, Mary J Y, Buffet C, Scolaro J M, Labayle D, Etienne J P

出版信息

Dig Dis Sci. 1981 Mar;26(3):232-6. doi: 10.1007/BF01391635.

DOI:10.1007/BF01391635
PMID:6972292
Abstract

Sixteen clinical and biological variables were recorded in 116 episodes of upper digestive tract hemorrhage of known cause in cirrhotic patients. One-dimensional analysis reveals a significant correlation between six variables and the rupture of esophagogastric varices, whereas multiple linear regression and partial correlation analysis reduces the significant variables to two: a history of digestive hemorrhage and the nonalcoholic etiology of the cirrhosis. A value of the discriminant function exists for which the specificity and, consequently, the positive predictive value are equal to 100%, but with a sensitivity of 39%. These results mean that, in an explanatory approach, partial correlation analysis seems to constitute an indispensable complement to analysis of clinical and biological variables, since it reduces the chances of unwarranted explanatory interpretation. However, in a pragmatic approach, the recording of 16 variables does not permit a clear discrimination between ruptured varices and nonruptured varices; this suggests that either other factor(s) remain to be discovered or else that those related to ruptured varices and to acute ulcerations are the same.

摘要

在116例已知病因的肝硬化患者上消化道出血发作中记录了16项临床和生物学变量。单因素分析显示,6个变量与食管胃静脉曲张破裂之间存在显著相关性,而多元线性回归和偏相关分析将显著变量减少至2个:消化性出血病史和肝硬化的非酒精性病因。存在一个判别函数值,其特异性以及因此的阳性预测值等于100%,但敏感性为39%。这些结果意味着,在解释性方法中,偏相关分析似乎是临床和生物学变量分析必不可少的补充,因为它减少了不必要的解释性解读的可能性。然而,在务实的方法中,记录16个变量并不能明确区分破裂的静脉曲张和未破裂的静脉曲张;这表明要么仍有待发现其他因素,要么与破裂的静脉曲张和急性溃疡相关的因素是相同的。

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Upper digestive tract hemorrhage in cirrhotic patients. Contribution of multidimensional analysis to the study of variables related to the cause of the hemorrhage.肝硬化患者的上消化道出血。多维度分析对与出血原因相关变量研究的贡献。
Dig Dis Sci. 1981 Mar;26(3):232-6. doi: 10.1007/BF01391635.
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引用本文的文献

1
The natural history of non-alcoholic cirrhosis.
Gastroenterol Jpn. 1984 Oct;19(5):430-5.
2
Portal hypertensive gastric mucosa: an endoscopic study.门静脉高压性胃黏膜:一项内镜研究
Gut. 1986 Oct;27(10):1199-203. doi: 10.1136/gut.27.10.1199.

本文引用的文献

1
Predictive value of a single diagnostic test in unselected populations.未经过筛选的人群中单一诊断测试的预测价值。
N Engl J Med. 1966 May 26;274(21):1171-3. doi: 10.1056/NEJM196605262742104.
2
[Emergency fibroscopy in digestive hemorrhages during cirrhosis. Apropos of 100 cases].[肝硬化消化出血时的急诊纤维内镜检查。附100例报告]
Nouv Presse Med. 1974 May 11;3(19):1227-30.
3
Upper gastrointestinal bleeding in cirrhosis: clinical and endoscopic correlations.肝硬化患者的上消化道出血:临床与内镜检查的相关性
Gut. 1976 Jan;17(1):37-40. doi: 10.1136/gut.17.1.37.
4
Upper gastrointestinal haemorrhage in hepatic cirrhosis: causes and relation to hepatic failure and stress.肝硬化患者上消化道出血:病因及其与肝衰竭和应激的关系
Lancet. 1977 Jan 29;1(8005):218-20. doi: 10.1016/s0140-6736(77)91015-7.