摘要
目的 对肝硬化多普勒超声测定的腹腔血管血流参数及临床指标行优化组合 ,并建立Logistic回归模型 ,探讨该模型的应用价值。方法 肝硬化 6 0例 ,其中出血 31例 ,无出血 2 9例 ,联合行门静脉、脾静脉及肠系膜上静脉多普勒血管血流参数测定 ,采用单因素非条件Logistic回归分析 ,在此基础上行多因素Logistic回归 ,经优化组合后建立回归模型 ,并以该模型对 14例患者随访 1年。结果 出血危险性与门静脉血流量Qpv、脾静脉血流量Qspv、肠系膜上静脉血流量Qsmv 及Qspv/Qpv 正相关 ,与血小板平均体积(MPV)负相关。多因素Logistic回归分析 ,Qspv、Qsmv及MPV是与出血相关的独立影响因素。结合Qspv、Qsmv及MPV建立的回归模型对出血预测的灵敏度 83 8% ,特异性 86 2 % ,阴性预测值 85 7% ,阳性预测值85 7%。结论 以超声多普勒联合检测脾静脉及肠系膜上静脉血流参数及MPV建立的Logistic回归模型在临床上无创性预测肝硬化门脉高压出血危险性是可行的。
Objective To create a logistic regression model of non-invasively predicting risk for variceal bleeding,based on Doppler ultrasound and clinical parameters.Methods 60 patients with hepatic cirrhosis were enrolled.Doppler parameters and clinical data were used for binary logistic analysis,and multivariate logistic regression model was developed.14 patients were followed up for 1 year.Results Parameters of Q pv ,Q spv ,Q smv adn Q spv /Q pv were positively correlated with risk of bleeding,while negatively correlated with mean platelet volume(MPV).Logistic regression model with Q spv ,Q smv and MPV had a sensitivity of 83.8%,specificity of 86.2% and a positive predicting value of 85.7%,negative predicting value of 85.7% in predicting risk of bleeding.Conclusion It is feasible to use logistic regression model for predicting risk of variceal bleeding in practice.
出处
《中华急诊医学杂志》
CAS
CSCD
2003年第11期755-757,共3页
Chinese Journal of Emergency Medicine
