Study On The Preliminary Value Of Emergency Hematologie Parameters To The Diagnosis Of Variceal Bleeding Caused By Portal Hypertension With Liver Cirrhosis

ObjectiveTo study the character of emergency hematologie parameters in upper gastrointestinal bleeding,screening the valued emergency hematologie parameters for identifying variceal bleeding caused by portal hypertension with liver cirrhosis.Methods1.From January 2009 to December 2014,116 emergency department patients with upper gastrointestinal bleeding of Second Affiliated of Suzhou University were chosen. Retrospective analysis was applied in studying the clinical case,design history information registration form,record the basic situation including medical history,laboratory tests,endoscopy tests and images information of each case study;The data input as a database was used by Microsoft Excel 2007 for Windows,use SPSS 19.0 for windows for statistical analysis.T test and rank test was used on quantitative data,chi-square test was used on qualitative data.Univariate Logistic analysis and Multivariate Logistic analysis Were used to analysis of independent risk factors,and built up Regression equation model.2.Select the method of comparative clinical data as age,sex,WBC,Hb,PLT,PT,INR,PTA,APTT,TB,ALB,A/G,PAB,ALT,AST,ALP,GGT,CHE、FDP、TB、DB to judge the statistical significance in two groups.Calculating the area under the receiver operating characteristic curve(ROC) of(AUC) and to compare the sensitivity and the specificity for comparing their predictive value.Results1.Age、Sex、ALP、GGT showed no statistical significance in two groups;Although ALT、AST showed statistical significance in two groups,they had no clinical significance for the sample mean of two groups are all in the normal range.WBC、Hb、PLT、PT、INR、PTA、APTT、FDP、ALB、A/G、PAB、CHE、TB、DB were not only showed statistical significance but also clinical significance.2.Univariate Logistic analysis showed that WBC、Hb、PLT、PT、INR、PTA、APTT、FDP 、 ALB 、 A/G 、 PAB 、 CHE 、 TB 、 DB had statistical significance in two groups(P<0.05);Multivariate Logistic analysis showed that PLT、INR showed statistical significance in two groups(P<0.05),the rest showed no statistical significance(P<0.05);Standardized regression coefficient Of PLT and INR respectively were-10.81 and 14.19;The equation was logit P =22.592×INR-0.058×PLT-21.354.The area under the ROC curve of the independent factors,PLT and INR were 0.973 and 0.976;The cut-off of PLT was 117x109/L;The sensitivity and the specificity of PLT respectively were 93.0% and 97.8%;The cut-off of INR was 1.18;The sensitivity and the specificity of INR respectively were 93.3% and 94.4%;PLT combined with INR in the diagnosis of the sensitivity and the specificity respectively were 91.1% and 100%.Conclusions1.WBC、Hb、PLT、PT、INR、PTA、APTT、FDP、ALB、A/G、PAB、CHE、TB、DB had important siginificance in identifying variceal bleeding or nonvariceal bleeding at early period.2.PLT and INR were the independent factors of diagnosising variceal bleeding,INR had a higher predictive value; PLT combined with INR could improve the diagnosis of the sensitivity and the specificity.