Evaluation of a new endoscopic index to predict first bleeding from the upper gastrointestinal tract in patients with cirrhosis
Evaluation of a new endoscopic index to predict first bleeding from the upper gastrointestinal tract in patients with cirrhosis
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预测肝硬化患者上消化道首次出血的新内镜指标的评价
DOI：
10.1002/hep.510240511
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发表时间：
1996
期刊：
影响因子：
13.5
通讯作者：
E. Pisi
中科院分区：
文献类型：
--
作者：
M. Zoli;C. Merkel;D. Magalotti;G. Marchesini;A. Gatta;E. Pisi
本研究的目的是前瞻性地评估意大利肝硬化项目（ILCP）食管静脉曲张分类的有效性，以及门脉高压的胃特征，在预测首次上消化道出血肝硬化。这些内镜参数预测出血的效率也与北意大利内镜俱乐部（NIEC）指数的效率进行了比较。344例食管静脉曲张但既往无任何出血的贲门失弛缓症患者入组研究。记录食管静脉曲张的以下内镜参数：位置、大小、占位、蓝色调和红色体征。胃静脉曲张被分级为不存在或存在，而充血性胃病被认为是不存在、轻度至中度或重度。所有患者均随访至首次上消化道出血和/或死亡，或至少24个月。没有患者接受任何预防出血的治疗。研究期间，65例患者发生上消化道流血的。单变量分析显示所有内镜参数均为出血的预测因子。根据多因素分析（考克斯模型），大小、胃底静脉曲张和充血性胃病是出血的唯一独立预测因素，并建立了以下预后指数（PI）：PI =（大小× 0.0395）+（充血性胃病× 0.878）+（胃底静脉曲张× 0.705）。该指数使用分离样本技术进行了验证，在预测出血方面似乎上级NIEC指数，可能有助于一级预防的决策。
The aim of this study was to prospectively evaluate the usefulness of the Italian Liver Cirrhosis Project (ILCP) classification of esophageal varices, together with the gastric features of portal hypertension, in predicting the first upper gastrointestinal bleeding in cirrhosis. The efficiency of these endoscopic parameters in predicting bleeding was also compared with the efficiency of the North Italian Endoscopic Club (NIEC) index. Three hundred forty‐four cirrhotic patients with esophageal varices but without any previous bleeding were enrolled in the study. The following endoscopic parameters of esophageal varices were recorded: location, size, occupancy, blue tone, and red color signs. Gastric varices were graded as absent or present, while congestive gastropathy was considered as absent, mild to moderate, or severe. All patients were followed until the first upper gastrointestinal bleeding and/or death, or for at least 24 months. No patient received any treatment to prevent bleeding. Sixty‐five patients bled from the upper gastrointestinal tract during the study. Univariate analysis showed that all endoscopic parameters were predictors of bleeding. According to multivariate analysis (Cox's model), size, gastric varices and congestive gastropathy were the only independent predictors of bleeding, and the following prognostic index (PI) was developed: PI = (size × 0.0395) + (congestive gastropathy × 0.878) + (gastric varices × 0.705). This index, which was validated using a split‐sample technique, and which appears to be superior to the NIEC index in predicting bleeding, may be useful in decision making for primary prophylaxis.
静脉曲张出血：生存分析的关键评估。
影响因子：
29.4
作者：
Smith,JL;Graham,DY
通讯作者：
Graham,DY