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[肝硬化患者药物治疗上消化道出血的早期预后因素。统计学研究(作者译)]

[Factors of early prognosis in medically treated haemorrhages of upper gastrointestinal tract in cirrhotic patients. Statistical study (author's transl)].

作者信息

Faivre J, Milan C, Joyeux J, Martin F, Dusserre L, Klepping C

出版信息

Pathol Biol (Paris). 1981 Sep;29(7):399-404.

PMID:7027149
Abstract

In order to define immediate criteria of prognosis for patients with cirrhosis, hospitalized in emergency for upper gastrointestinal tract haemorrhage, 164 cases of haemorrhages medically treated were reviewed. A prognostic study of each variant points to the clinical endoscopic and biological data connected with death. That study illustrates the prognostic value of traditional data. Patients who died within the first 30 days had a significantly higher incidence of hepatic encephalopathy, hematemesis, ascites, low blood pressure, bleeding oesophageal varices during endoscopy,. hypoprothrombinemia, hyperbilirubinemia. Those who survived had a significantly higher incidence of aspirin intake, numerous haemorrhages, good state of health, non bleeding peptic ulcer. Several series of multivariant analysis : multiple regression and linear discrimination, differing from one another in variates were done. They have allowed identification of 11 variables used in establishing a prognostic index. In the series, it gives an 87% probability of correct differentiation. Such an index allows an objective estimate of the value and limits of a group of patients in which the efficiency of other treatments could be tested in controlled trials.

摘要

为了确定因上消化道出血而急诊住院的肝硬化患者的近期预后标准,我们回顾了164例接受内科治疗的出血病例。对每个变量的预后研究指向与死亡相关的临床、内镜和生物学数据。该研究阐明了传统数据的预后价值。在最初30天内死亡的患者,肝性脑病、呕血、腹水、低血压、内镜检查时食管静脉曲张出血、低凝血酶原血症、高胆红素血症的发生率显著更高。存活的患者阿司匹林摄入、多次出血、健康状况良好、非出血性消化性溃疡的发生率显著更高。进行了几组多变量分析:多元回归和线性判别,变量各不相同。它们使得能够识别用于建立预后指数的11个变量。在该系列中,其正确区分的概率为87%。这样一个指数能够客观评估一组患者的价值和局限性,在这些患者中可以在对照试验中测试其他治疗方法的疗效。

相似文献

1
[Factors of early prognosis in medically treated haemorrhages of upper gastrointestinal tract in cirrhotic patients. Statistical study (author's transl)].[肝硬化患者药物治疗上消化道出血的早期预后因素。统计学研究(作者译)]
Pathol Biol (Paris). 1981 Sep;29(7):399-404.
2
[Factors of early prognosis in medically treated haemorrhages of upper gastrointestinal tract in cirrhotic patients. Statistical study (author's transl)].[肝硬化患者药物治疗上消化道出血的早期预后因素。统计学研究(作者译)]
Sem Hop. 1982 Mar 11;58(10):607-12.
3
First bleeding episode from oesophageal varices in cirrhotic patients: a prospective study of endoscopic predictive factors.肝硬化患者食管静脉曲张首次出血发作:内镜预测因素的前瞻性研究
Ital J Gastroenterol. 1995 Sep;27(7):345-8.
4
Development and validation of a prognostic index predicting death after upper gastrointestinal bleeding in patients with liver cirrhosis: a multicenter study.肝硬化患者上消化道出血后死亡预测预后指数的开发与验证:一项多中心研究
Am J Gastroenterol. 1994 Sep;89(9):1528-36.
5
[Prediction of bleeding risks and death in cirrhosis based on hemodynamic and metabolic variables. A study of patients with esophageal varices without previous bleeding].基于血流动力学和代谢变量预测肝硬化患者的出血风险和死亡。一项针对既往无出血史的食管静脉曲张患者的研究
Ugeskr Laeger. 1995 Sep 25;157(39):5389-93.
6
[Prognostic indicators in patients with liver cirrhosis admitted to an intensive care unit].[入住重症监护病房的肝硬化患者的预后指标]
Gastroenterol Clin Biol. 1996;20(3):263-8.
7
[Emergency endoscopy in patients with liver cirrhosis].[肝硬化患者的急诊内镜检查]
Leber Magen Darm. 1983 Jan;13(1):21-6.
8
[Prognostic factors of early mortality in the 1st episode of hemorrhage caused by esophageal varices].[食管静脉曲张出血首发 episode 早期死亡的预后因素] (注:这里“episode”不太明确准确含义,可结合上下文进一步确定更合适的表述)
Rev Esp Enferm Dig. 1996 Jun;88(6):395-9.
9
Evaluation of a new endoscopic index to predict first bleeding from the upper gastrointestinal tract in patients with cirrhosis.评估一种预测肝硬化患者上消化道首次出血的新型内镜指数。
Hepatology. 1996 Nov;24(5):1047-52. doi: 10.1053/jhep.1996.v24.pm0008903373.
10
Role of serum creatinine and prognostic scoring systems in assessing hospital mortality in critically ill cirrhotic patients with upper gastrointestinal bleeding.血清肌酐和预后评分系统在评估肝硬化合并上消化道出血重症患者医院死亡率中的作用
J Nephrol. 2003 Jul-Aug;16(4):558-65.

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