| 郑晖,黄兢姚,黄宁,谢杭,林俊清,池桢,柯坤,严乐业,杨维竹.TIPS治疗食管胃底静脉曲张出血预后影响因素分析[J].中国介入影像与治疗学,2019,16(5):270-274 |
| TIPS治疗食管胃底静脉曲张出血预后影响因素分析 |
| Prognostic factors of TIPS in treatment of gastroesophageal varices bleeding |
| 投稿时间：2018-07-23 修订日期：2019-04-14 |
| DOI：10.13929/j.1672-8475.201807028 |
| 中文关键词: 门体分流术,经颈静脉肝内 食管和胃静脉曲张 出血 预后 |
| 英文关键词:portosystemic shunt, transjugular intrahepatic esophageal and gastric varices hemorrhage prognosis |
| 基金项目:福建省微创医学中心建设项目（No.[2017]171）。 |
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| 中文摘要: |
| 目的 分析影响TIPS治疗食管胃底静脉曲张出血（EGVB）预后的因素。方法 回顾性分析68例接受TIPS治疗的EGVB患者的资料。采用Kaplan-Meier方法计算术后累积生存率，不同患者间生存率比较采用log-rank检验。以Cox回归模型分析影响预后的因素，并以ROC曲线确定其预测经TIPS治疗后EGVB患者预后的最佳截点。结果 TIPS术后患者1、2、3年累积生存率分别为90.7%、82.2%和77.9%。患者年龄、术前血清白蛋白为影响TIPS治疗EGVB的预后因素。ROC曲线分析显示，以患者年龄、术前血清白蛋白评估EGVB患者TIPS术后1年生存预后的AUC分别为0.923（P=0.001）和0.183（P=0.011），年龄67.5岁为最佳截点。年龄≤ 67.5岁患者术后1年累积生存率明显高于年龄> 67.5岁者（96.4% vs 64.3%，χ2=10.785，P=0.001）。结论 年龄及术前血清白蛋白是预测TIPS治疗EGVB患者生存情况的独立因素；年龄> 67.5岁患者预后较差。 |
| 英文摘要: |
| Objective To analyze the prognostic factors of transjugular intrahepatic portosystemic shunt (TIPS) in treatment of esophageal and gastric varices bleeding (EGVB). Methods A retrospective analysis was performed on 68 patients with EGVB who underwent TIPS. Kaplan-Meier method was used to calculate the cumulative survival after treatment, and the differences of cumulative survival were compared using log-rank test. Multivariate analysis of prognostic factors was carried out with Cox proportional hazards regression model, and ROC curve was used to determine the optimal cut-off value of prognostic factors. Results The 1-, 2-and 3-year survival rate was 90.7%, 82.2% and 77.9% respectively after TIPS procedures. Cox regression univariate and multivariate analysis showed that the age (P=0.009) and preoperative serum albumin (P=0.024) were independent prognostic factors. The area under the ROC curve of age for assessing whether the survival time more than 1 year was 0.923 (P=0.001), while that of preoperative serum albumin was 0.183 (P=0.011). Patient's age of 67.5 years was the optimal cut-off value. The 1-year cumulative survival rate of patients' aged ≤ 67.5 years was statistically significant higher than that of those older than 67.5 years (96.4% vs 64.3%, χ2=10.785, P=0.001). Conclusion Patients' age and preoperative serum albumin are independent predictors for the survival of EGVB after TIPS. Postoperative prognosis of patients' aged > 67.5 years is unfavorable. |
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