开发和验证用于预测内镜血静衰竭的诺姆图,以预测患有食道水出血的肝患者的内镜血静衰竭
Yali Guo1, Hui Ouyang2, Jingling Su3
1Endoscopy Center, Xiamen Hospital of Traditional Chinese Medicine (Xiamen Hospital Affiliated with Dongzhimen Hospital of Beijing University of Chinese Medicine), Xiamen, China.
Frontiers in medicine
|October 23, 2025
概括
一种新的诺米图有效地预测了急性食管胃水出血 (EGVB) 的肝硬化患者的内静止失败. 该工具有助于早期识别高风险个体,以便及时进行干预.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内镜手术 进行内镜手术
背景情况:
- 急性食管胃水出血 (EGVB) 是肝硬化患者的一种严重并发症.
- 内镜血静是主要的治疗方法,但失败可能导致再出血和增加死亡率.
- 早期识别患有治疗失败高风险的患者对于优化管理至关重要.
研究的目的:
- 开发和验证一个预测模型,用于内镜血静止失败的中国患者肝硬化EGVB.
- 为了确定治疗失败的独立预测因素.
- 为在风险分层中创建一个用于临床使用的名图.
主要方法:
- 对296名患有EGVB的肝硬化患者进行了回顾性分析,这些患者正在接受紧急内镜治疗.
- 使用LASSO回归进行变量选择,并通过多变量逻辑回归识别独立预测因子.
- 使用Bootstrap重新采样构建和内部验证Nomogram;通过ROC曲线,校准图和决策曲线分析 (DCA) 评估性能.
主要成果:
- 内镜衰竭的累积发病率为7.8%.
- 失败的独立预测因素包括冲击指数 (SI) >1.2,红色 (RC) 标志,内镜期间的活跃出血,以及儿童-图尔科特-普格 (CTP) 评分.
- 与CTP,MELD和Rockall分数相比,开发的名图显示出优异的预测性能 (AUC = 0.890).
结论:
- 一个经过验证的整合SI,RC标志,活跃出血和CTP的nomogram有效地预测了肝硬化EGVB患者内镜血静失效.
- 这种工具有助于早期风险分层和及时的临床干预.
- 与现有的评分系统相比,该名图为预测EGVB治疗结果提供了更高的准确性.
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