aims65评分对内镜止血必要性的预测价值.docVIP

AIMS65评分对内镜止血必要性的预测价值 　　【摘要】 目的 评估AIMS65评分在急性非静脉曲张性上消化道出血患者应用中， 对内镜止血必要性的预测价值。方法 140例急性非静脉曲张性上消化道出血患者， 分别予格拉斯哥-布拉奇福德出血评分 （GBS）评分、内镜前Rockall评分、AIMS65评分， 对比内镜止血必要性的预测效能。结果 AIMS65评分预测内镜下止血必要性的敏感性为88.9%、特异性为83.2%、阳性预测值为55.8%、阴性预测值为96.9%。GBS评分预测内镜下止血必要性的敏感性为70.4%、特异性为79.6%、阳性预测值为45.2%、阴性预测值为91.8%。?染登?Rockall评分预测内镜下止血必要性的敏感性为74.1%、特异性为77.9%、阳性预测值为44.4%、阴性预测值为92.6%。AIMS65评分预测内镜下止血必要性的敏感性、特异性、阳性预测值、阴性预测值均高于GBS评分及内镜前Rockall评分。结论 AIMS65评分相对于GBS评分和内镜前Rockall评分， 在预测内镜止血必要性方面具有更好的预测效能， 且更为简便， 值得临床进一步推广应用。 　　【关键词】 AIMS65评分；急性非静脉曲张性上消化道出血；内镜止血；预测 　　【Abstract】 Objective To evaluate the predictive value of AIMS65 score for endoscopic hemostasia necessity in acute non-variceal upper gastrointestinal bleeding. Methods A total of 140 acute non-variceal upper gastrointestinal bleeding patients were respectively evaluated by Glasgow-Blatchford bleeding （GBS） score， pre-endoscopy Rockall score and AIMS65 score. Prediction efficiency of endoscopic hemostatic necessity was compared. Results Endoscopic hemostatic necessity predicted by AIMS65 score with sensibility as 88.9%， specificity as 83.2%， positive predictive value as 55.8%， and negative predictive value as 96.9%. Endoscopic hemostatic necessity predicted by GBS score with sensibility as 70.4%， specificity as 79.6%， positive predictive value as 45.2%， and negative predictive value as 91.8%. Endoscopic hemostatic necessity predicted by pre-endoscopy Rockall score with sensibility as 74.1%， specificity as 77.9%， positive predictive value as 44.4%， and negative predictive value as 92.6%. Endoscopic hemostatic necessity predicted by AIMS65 score had higher sensibility， specificity， positive predictive value and negative predictive value than GBS score and pre-endoscopy Rockall score. Conclusion AIMS65 score shows better prediction performance and more convenient than GBS score and pre-endoscopic Rockall score in the prediction of endoscopic hemostatic necessity， and it is worth further clinical popularization and application. 　　【Key