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国际临床研究杂志

International Journal of Clinical Research

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International Journal of Clinical Research. 2026; 10: (3) ; 10.12208/j.ijcr.20260125 .

Platelet parameters combined with AMIS65 score predict the risk of short-term upper gastrointestinal bleeding in patients with liver cirrhosis
血小板参数联合AMIS65评分预测肝硬化短期上消化道出血的风险

作者： 刘佩1, 张顺玲1, 曾雪丽1, 李心怡1, 郑盛2 *, 杨涓3

1大理大学临床医学院 云南大理

2大理大学第二附属医院 云南昆明

3云南省第二人民医院 云南昆明

*通讯作者： 郑盛,单位：大理大学第二附属医院 云南昆明; ；

引用本文: 刘佩, 张顺玲, 曾雪丽, 李心怡, 郑盛, 杨涓 血小板参数联合AMIS65评分预测肝硬化短期上消化道出血的风险[J]. 国际临床研究杂志, 2026; 10: (3) : 36-42.
Published: 2026/3/28 9:45:16

摘要

目的 探究血小板计数（platelet count, PLT）、血小板分布宽度（platelet distribution width, PDW）、血小板平均体积（mean platelet volume, MPV）、血小板压积（plateletcrit, PCT）等血小板参数联合AMIS65评分在预测肝硬化患者短期内发生上消化道出血风险方面的效能。方法 选取2020年1月-2024年7月在大理大学第二附属医院诊治的135例肝硬化患者，根据患者是否在短期内（＜3个月）发生上消化道出血，将其分为非出血组（71例）和出血组（64例），比较两组血小板参数和AMIS65评分水平，应用Logistic回归分析探讨肝硬化短期内发生上消化道出血危险因素；绘制ROC曲线分析血小板参数和AMIS65评分的联合作用，评估其对肝硬化患者短期内发生上消化道出血的预测价值。结果 出血组患者PLT（55.50（42.00~83.50）VS 85.00（75.00~112.00），P＜0.05）、PCT（0.07（0.04~0.10） VS 0.11（0.08~0.17），P＜0.05）低于非出血组；出血组患者PDW（17.55（13.00~19.75） VS 12.40（11.10~13.80）P＜0.05）、MPV（11.70（10.93~13.12） VS 11.20（10.40~12.30），P＜0.05）、AMIS65评分（1.05（1.00~2.00） VS 1.00（0~1.00），P＜0.05）高于非出血组；Logistic回归分析显示，PDW、AMIS65评分是肝硬化患者短期内发生上消化道出血的独立危险因素（P均＜0.05），ROC曲线分析显示PLT、PDW、MPV、PCT、AMIS65评分单独检测肝硬化患者短期内发生上消化道出血的AUC分别为0.824(95%CI 0.752~0.896)、0.813 (95%CI 0.739~0.887)、0.639(95%CI 0.546~0.732)、0.823(95%CI 0.755~0.890)、0.761(95%CI 0.680~0.842)，PLT、PDW、MPV、PCT联合AMIS65评分检测肝硬化患者短期内发生上消化道出血的AUC为0.915(95%CI 0.868~0.962)，优于单一指标的预测效能（P＜0.05）。结论 血小板参数联合AMIS65评分对肝硬化短期内发生上消化道出血的风险评估具有一定的价值,联合检测的AUC为0.915(95%CI 0.868~0.962)，显著优于任意单一指标（P＜0.05）。

关键词： 肝硬化；上消化道出血；血小板参数；AMIS65评分；风险预测

Abstract

Objective To investigate the efficacy of platelet parameters such as platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), platelet compression volume (PCT) and other platelet parameters in combination with the efficacy of AMIS65 score in predicting the risk of upper gastrointestinal bleeding in cirrhotic patients in the short term.
Methods One hundred thirty-five patients with cirrhosis who were diagnosed and treated at the Second Affiliated Hospital of Dali University from January 2020 to July 2024 were selected and divided into the non-bleeding group (71 patients) and the bleeding group (64 patients) according to whether or not they had an upper gastrointestinal bleeding in a short period of time (<3 months), and the levels of the platelet parameters and AMIS65 scores of the two groups were compared to each other, and the Logistic regression analysis was applied to investigate the effectiveness of the platelet parameters and AMIS65 scores in predicting the risk of upper gastrointestinal bleeding in a short period of time. Logistic regression analysis was applied to explore the risk factors for the occurrence of upper gastrointestinal bleeding in the short term in cirrhosis; ROC curves were drawn to analyze the combined effect of platelet parameters and AMIS65 score and evaluate their predictive value for upper gastrointestinal bleeding in patients with liver cirrhosis within a short period.
Results PLT (55.50 (42.00~83.50) VS 85.00 (75.00~112.00), P<0.05) and PCT (0.07 (0.04~0.10) VS 0.11 (0.08~0.17), P<0.05) were lower in patients of the bleeding group than those of the non-bleeding group; PDW (17.55 (13.00~19.75) VS 12.40 (11.10~13.80) P < 0.05) were lower in the bleeding group than in the non-bleeding group. MPV (11.70 (10.93~13.12) VS 11.20 (10.40~12.30), P < 0.05), and AMIS65 score (1.05 (1.00~2.00) VS 1.00 (0~1.00), P < 0.05) were higher than those in the non-bleeding group; logistic regression analysis showed that PDW and AMIS65 scores were independent risk factors for the occurrence of short-term upper gastrointestinal bleeding in patients with cirrhosis (both P < 0.05), and ROC curve analysis showed that the AUC of PLT, PDW, MPV, PCT, and AMIS65 scores alone for detecting the occurrence of short-term upper gastrointestinal bleeding in cirrhotic patients were 0.824 (95% CI 0.752~0.896), 0.813 (95% CI 0.739~0.887), 0.639 (95% CI 0.546~0.732), 0.823 (95% CI 0.755~0.890), and 0.761 (95% CI 0.680~0.842), respectively, and that PLT, PDW, MPV, and PCT combined with AMIS65 score to detect short-term occurrence of upper gastrointestinal bleeding in patients with cirrhosis had an AUC of 0.915 (95% CI 0.868~0.962), which was superior to the predictive efficacy of a single index (P<0.05).
Conclusion   The combined assessment of platelet parameters and the AMIS65 score demonstrates significant value in evaluating the risk of short-term upper gastrointestinal bleeding in patients with liver cirrhosis. The combined test achieved an AUC of 0.915 (95% CI 0.868~0.962), which was significantly superior to any single indicator (P < 0.05).

Key words： Cirrhosis; Upper gastrointestinal bleeding; Platelet parameters; AMIS65 score; Risk prediction

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