摘要
目的探讨血清内皮素1(ET-1)、可溶性白细胞介素2受体(sIL-2R)与肝硬化食管胃底静脉曲张出血(EGVB)患者疾病预后的关系。方法选取2021年1月至2023年3月黄石市第五医院收治的肝硬化EGVB患者155例,根据随访1年疾病预后分为不良预后组(72例)和良好预后组(83例),检测血清ET-1、sIL-2R水平。单因素和多因素Logistic回归分析影响肝硬化EGVB患者疾病预后的因素,受试者工作特征(ROC)曲线评估血清ET-1、sIL-2R水平对预后的预测价值。结果随访1年,155例肝硬化EGVB患者不良预后发生率为46.45%(72/155)。单因素分析显示,肝腹水、白蛋白、血红蛋白、Child-Turcotte-Pugh(CTP)评分、终末期肝病模型(MELD)评分、ET-1、sIL-2R与肝硬化EGVB患者疾病预后相关(均P<0.05)。白蛋白水平升高是肝硬化EGVB患者不良预后的独立保护因素(OR=0.755,95%CI:0.631~0.903),CTP评分增加(OR=3.167,95%CI:1.464~6.852)、MELD评分增加(OR=2.320,95%CI:1.432~3.758)、ET-1升高(OR=1.075,95%CI:1.036~1.115)、sIL-2R升高(OR=1.011,95%CI:1.006~1.017)(均P<0.05)是肝硬化EGVB患者不良预后的独立危险因素。血清ET-1、s IL-2R水平联合预测肝硬化EGVB患者不良预后的曲线下面积为0.878,高于任一指标单独预测的0.795、0.789(Z=3.178、3.000,均P<0.05)。结论肝硬化EGVB患者血清ET-1、s IL-2R水平升高,且是不良预后独立危险因素,二者联合预测肝硬化EGVB患者不良预后的价值较高。
Objective To investigate the relationship between serum endothelin-1(ET-1),soluble interleukin-2 receptor(sIL-2R)and the prognosis of patients with cirrhosis and esophagogastric variceal bleeding(EGVB).Methods A total of 155 cirrhosis EGVB patients admitted to Huangshi Fifth Hospital from January 2021 to March 2023 were selected.Patients were divided into poor prognosis group(n=72)and good prognosis group(n=83)according to the disease outcome one year after follow-up,and serum levels of ET-1 and sIL-2R were detected.Factors affecting the prognosis were analyzed by univariate and multivariate logistic regression analysis,and the predictive value of serum ET-1 and sIL-2R levels was evaluated by receiver operating characteristic(ROC)curve.Results The incidence of poor prognosis was 46.45%(72/155)at 1-year follow-up.Univariate analysis showed that hepatic ascites,albumin,hemoglobin,Child-Turcotte-Pugh(CTP)score,model for end-stage liver disease(MELD)score,ET-1 and sIL-2R were associated with prognosis(all P<0.05).An elevated albumin level was an independent protective factor(OR=0.755,95%CI:0.631-0.903).Independent risk factors were higher CTP score(OR=3.167,95%CI:1.464-6.852),higher MELD score(OR=2.320,95%CI:1.432-3.758),elevated ET-1(OR=1.075,95%CI:1.036-1.115),and elevated sIL-2R(OR=1.011,95%CI:1.006-1.017)(all P<0.05).The area under the curve(AUC)for combined detection of ET-1 and sIL-2R in predicting poor prognosis was 0.878,significantly higher than that of individual detection(0.795 and 0.789;Z=3.178,3.000,both P<0.05).Conclusion Elevated serum ET-1 and sIL-2R levels were independent risk factors for poor prognosis in cirrhosis EGVB patients.Their combination has a high predictive value for poor prognosis.
作者
程鲲鹏
朱珊玲
马敬
刘洋
黄刘密
高茜
CHENG Kunpeng;ZHU Shanling;MA Jing;LIU Yang;HUANG Liumi;GAO Qian(Department of Gastroenterology,Huangshi Fifth Hospital,Huangshi,Hubei 435000,China)
出处
《转化医学杂志》
2025年第7期1-6,共6页
Translational Medicine Journal
基金
湖北省自然科学基金创新发展联合基金项目(WJ2022H039)。
