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目的探讨Rockall危险积分在急性非静脉曲张性上消化道出血患者中的应用,评估其对死亡及再出血的预测能力准确性。方法回顾性分析上海浦东医院消化科ANVUGIB患者474例,按年龄段分为<40岁组、40~59岁组、60~79岁组和≥80岁组,应用Rockall评分系统进行评分,采用受试者工作特征曲线(ROC)下面积(AUC)评估其对ANVUGIB再出血及死亡的预测能力。结果 474例ANVUGIB患者中男性与女性之比约为2.36∶1,死亡22例(4.64%),再出血54例(11.39%)。Rockall评分系统预测死亡的AUC=0.849(P<0.05),预测再出血的AUC=0.675(P>0.05)。各组再出血率分别为10%、7.53%、12.58%、19.58%。Rockall评分系统评估各组再出血率AUC分别为0.610、0.740、0.632、0.727。各组死亡率分别为0%、5.48%、2.65%、10.3%。结论 Rockall评分系统对ANVUGIB死亡的预测能力良好。Rockall评分系统对40~59岁组、≥80岁组ANVUGIB患者再出血预测价值较高。
Objective To explore the application of Rockall’s risk score in patients with acute non-variceal upper gastrointestinal bleeding and evaluate its accuracy in predicting mortality and rebleeding. Methods A total of 474 ANVUGIB patients were enrolled in this study. The patients were divided into the following groups: <40 years old, 40-59 years old, 60-79 years old and ≥80 years old. The patients were evaluated by Rockall scoring system. The area under the receiver operating characteristic curve (ROC) was used to assess its ability to predict ANVUGIB rebleeding and death. Results The ratio of male to female in 474 ANVUGIB patients was about 2.36:1. There were 22 deaths (4.64%) and 54 (11.39%) rebleeds. The AUC predicted by the Rockall scoring system was 0.849 (P <0.05), and the predicted AUC of rebleeding was 0.675 (P> 0.05). The rates of rebleeding in each group were 10%, 7.53%, 12.58% and 19.58%, respectively. Rockall score system to assess the rate of hemorrhage in each group AUC 0.610,0.740,0.632,0.727. Mortality rates in each group were 0%, 5.48%, 2.65% and 10.3% respectively. Conclusions The Rockall scoring system is good at predicting the death of ANVUGIB. Rockall scoring system for 40 to 59 years old group, ≥ 80 years old ANVUGIB patients with higher predictive value of rebleeding.