Changes of blood cell parameters，renal function and nutritional score and their correlation with prognosis in cirrhotic patients with portal hypertension and acute upper gastrointestinal hemorrhage

doi:10.3877/cma.j.issn.2095-2015.2025.02.010

Abstract

Abstract:

Objective

To investigate the changes of blood cell parameters，serum prealbumin（PA），blood urea nitrogen/creatinine （BUN/Cr） ratio，prognostic nutrition index （PNI），modified critical illness nutritional risk （mNUTRIC） score and their correlation with prognosis in cirrhotic patients with portal hypertension and acute upper gastrointestinal hemorrhage.

Methods

A total of 120 patients with cirrhotic portal hypertension accompanied with upper gastrointestinal acute hemorrhage admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University and Hanzhong Central Hospital from January 2020 to December 2023 were selected as study group，and 100 patients with cirrhotic portal hypertension were selected as control group. Blood cell parameters ［erythrocyte distribution width （RDW），platelet（PLT），platelet volume （PCT），hematocrit （HCT），mean platelet volume （MPV），serum PA，BUN/Cr ratio，PNI and mNUTRIC score were compared between the two groups，and the changes of the above indexes in patients with different prognosis were compared. The correlations between blood cell parameters，serum PA，BUN/Cr ratio，PNI，mNUTRIC score and prognosis in cirrhotic patients with portal hypertension and acute upper gastrointestinal hemorrhage were analyzed by Pearson correlation analysis.

Results

RDW，MPV，BUN/Cr ratio and mNUTRIC score in study group were higher than those in control group，while RDW，PLT，PCT，HCT，MPV，serum PA and PNI levels were lower than those in control group，with statistically significant differences （P＜0.05）； RDW，MPV，BUN/Cr ratio and mNUTRIC score in death group were higher than those in survival group，while RDW，PLT，PCT，HCT，MPV，serum PA and PNI levels were lower than those in survival group，with statistically significant differences （P＜0.05）； the results of Pearson correlation analysis showed that RDW，MPV，BUN/Cr ratio and mNUTRIC score were positively correlated with prognosis，while RDW，PLT，PCT，HCT，MPV，serum PA and PNI were negatively correlated with prognosis （P＜0.05）.

Conclusion

The changes of blood cell parameters，serum PA，BUN/Cr ratio，PNI and mNUTRIC score in cirrhotic patients with portal hypertension accompanied with acute upper gastrointestinal bleeding are closely related to the prognosis，and monitoring these indicators can help advance intervention and improve prognosis.

Key words: Cirrhosis, Portal hypertension, Upper gastrointestinal hemorrhage, Prealbumin, Blood urea nitrogen, Creatinine, Nutritional risk, Prognosis

Zhen Chen, Tianlei Yu, Xiaochao Liu, Meng Yin. Changes of blood cell parameters，renal function and nutritional score and their correlation with prognosis in cirrhotic patients with portal hypertension and acute upper gastrointestinal hemorrhage[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(02): 149-154.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2025.02.010

https://zhxhbyyxzz.cma-cmc.com.cn/EN/Y2025/V15/I02/149

Figures/Tables 5

组别	例数	性别（例）		既往疾病史（例）			体重指数（kg/m²， $\overset{ˉ}{x}$ ± s ）	年龄（岁， $\overset{ˉ}{x}$ ± s ）
组别	例数	男	女	糖尿病	高血压	高血脂症	体重指数（kg/m²， $\overset{ˉ}{x}$ ± s ）	年龄（岁， $\overset{ˉ}{x}$ ± s ）
研究组	120	65	55	38	35	40	23.05±1.33	55.83±4.16
对照组	100	52	48	30	25	33	22.93±1.28	55.79±4.10
χ ²/t 值		0.103		0.071	0.477	0.003	0.678	0.089
P 值		0.748		0.790	0.490	0.958	0.499	0.929

组别	例数	性别（例）		既往疾病史（例）			体重指数（kg/m²， $\overset{ˉ}{x}$ ± s ）	年龄（岁， $\overset{ˉ}{x}$ ± s ）
组别	例数	男	女	糖尿病	高血压	高血脂症	体重指数（kg/m²， $\overset{ˉ}{x}$ ± s ）	年龄（岁， $\overset{ˉ}{x}$ ± s ）
研究组	120	65	55	38	35	40	23.05±1.33	55.83±4.16
对照组	100	52	48	30	25	33	22.93±1.28	55.79±4.10
χ ²/t 值		0.103		0.071	0.477	0.003	0.678	0.089
P 值		0.748		0.790	0.490	0.958	0.499	0.929

组别	例数	RDW（fL）	PLT（×10⁹/L）	PCT（%）	HCT（%）	MPV（fL）	PA（g/L）	BUN/Cr	PNI	mNUTRIC 评分
研究组	120	14.57±2.00	90.12±15.22	0.09±0.02	29.48±5.20	13.20±1.57	0.18±0.05	37.21±5.50	40.05±1.86	5.50±0.46
对照组	100	13.23±2.12	115.68±20.16	0.13±0.04	45.13±5.79	12.45±1.24	0.35±0.10	26.45±7.43	45.14±2.15	4.13±0.30
t 值		4.815	11.123	9.610	21.108	3.875	16.337	12.324	18.825	25.587
P 值		0.000	0.000	0.000	0.000	0.000	0.000	0.000	0.000	0.000

组别	例数	RDW（fL）	PLT（×10⁹/L）	PCT（%）	HCT（%）	MPV（fL）	PA（g/L）	BUN/Cr	PNI	mNUTRIC 评分
死亡组	21	19.50±3.18	80.23±12.11	0.07±0.01	21.54±4.53	13.55±1.01	0.14±0.03	40.10±8.12	27.44±5.35	5.87±0.57
存活组	99	13.14±4.25	118.40±18.16	0.11±0.03	31.10±6.00	12.17±1.44	0.25±0.06	35.73±6.22	32.40±4.86	3.21±0.30
t 值		7.820	11.919	10.848	8.271	5.246	12.426	2.322	3.917	20.736
P 值		0.000	0.000	0.000	0.000	0.000	0.000	0.000	0.000	0.000

指标	预后
指标	r 值	P 值
RDW	0.508	＜0.05
PLT	-0.646	＜0.05
PCT	-0.524	＜0.05
HCT	-0.508	＜0.05
MPV	0.362	＜0.05
PA	-0.612	＜0.05
BUN/Cr 比值	0.244	＜0.05
PNI	-0.360	＜0.05
mNUTRIC 评分	0.916	＜0.05

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