目的 汇总分析肝硬化患者消化道出血风险预测模型，为今后模型的建立和优化提供参考。方法   系统检索中国知网、维普、PubMed数据库在2025年4月22日前公开发表的所有肝硬化患者消化道出血风险预测模型，按纳入标准筛选文献，对最终纳入文章分析摘录并系统汇总，包括模型特征、危险因素及模型预测评估效果等信息。结果   共检索3 603篇预测模型相关研究论文，最终纳入30篇，其中中国27篇、韩国1篇、印度1篇、埃及1篇。22项研究收集了肝硬化病因，其中病毒性肝病最多（72.94%，2 922/4 006），药物性肝病及非酒精性脂肪性肝病最少（均为0.02%，1/4 006）。在研究类型上，有28篇单中心研究，2篇为多中心研究，其中有12个模型未进行验证，只有1个模型进行了外部验证，其余模型只进行了内部验证，曲线下面积（AUC）范围0.680~0.994。根据模型纳入因素特点，分为血常规指标、凝血指标、生化指标、影像学指标、复合指标、其他指标共6种，其中纳入因素最多为影像学指标，最少为凝血指标。在纳入危险因素中，第1位为门静脉直径，第2位为血小板计数，第3位为血红蛋白水平及脾脏硬度，所有因素中与脾脏相关的指标最多。结论   肝硬化患者消化道出血风险预测模型研究质量有待提升，影像学指标应用最广，脾脏相关指标重要性突出，门静脉直径、血小板计数、血红蛋白水平及脾脏硬度为最常用的危险预测因素。

       Objective  To  summarize and analyze the  prediction models for gastrointestinal  bleeding  risk in  patients with cirrhosis，providing references for the establishment and optimization of future models．Methods  A systematic search was conducted in CNKI，VIP，and PubMed for all published prediction models for gastrointestinal bleeding risk in patients with cirrhosis before April 22，2025．Articles were screened according to the inclusion criteria，and the finally included articles were analyzed and summarized，including model characteristics，risk factors，and model prediction evaluation effects．Results  A total of 3 603 related research papers on prediction models were initially retrieved，and 30 were finally included，with 27 from China，one from South Korea，one from India，and one from Egypt．Among the 22 studies that collected the etiology of cirrhosis，viral hepatitis was the most common（72.94%，2 922/4 006），while drug-induced liver disease and non-alcoholic fatty liver disease were the least common（0.02%，1/4 006）．In terms of study type，28 were single-center studies and two were multicenter studies．Among them，12 models were not validated，only one model was externally validated，and the rest were only internally validated，with an area under the curve range of 0.680-0.994．According to the characteristics of the factors included in the models，they were divided into six types of indicators：blood routine，coagulation，biochemistry，imaging，composite，and others，among which imaging indicators were the most common and coagulation indicators were the least．In the included risk factors，the first was portal vein diameter，the second was platelets count，and the third was hemoglobin level and spleen stiffness，with the most factors related to the spleen．Conclusions  The quality of studies on prediction models for gastrointestinal bleeding risk in cirrhosis patients needs to be improved．Imaging indicators are the most widely used，and spleen-related indicators are of prominent importance，with portal vein diameter，platelets count，hemoglobin level，and spleen stiffness being the most commonly used risk prediction factors．

目的 比较替格瑞洛片与氯吡格雷片在临床住院急性冠状动脉综合征患者使用中的出血风险。方法 选择2016年1月—2016年11月于我院心血管内科住院的264例急性冠状动脉综合征患者。将患者随机分为两组,替格瑞洛组(A组)131例,氯吡格雷组(B组)133例。对两组患者出血情况进行比较。结果 住院期间两组患者均无严重心血管不良事件(MACE),均未见黑便及需要输血的严重出血。轻微出血患者数,A组:17例占13.0%(17/131),B组:3例占2.3%(3/133),A组轻微出血风险高于B组,差异有统计学意义(P＜0.01)。结论 替格瑞洛轻微出血风险发生率高于氯吡格雷,均未见MACE发生及严重出血病例,临床使用中需注意此问题,并建议更多的临床研究出现。

Objective To compare the risk of bleeding between Clopidogrel and Ticagrelor in inpatients with acute coronary syndrome. Methods 264 patients with acute coronary syndrome who were admitted to our hospital from January 2016 to October 2016 were selected. The patients were divided into two groups randomly, 131 cases with taking Ticagrelor tablets and 133 cases with taking Clopidogrel tablets. The risk of bleeding of the two groups were compared. Results There were no serious adverse cardiovascular events (MACE) between two groups. Severe bleeding events were not obsereved in Ticagrelor and Clopidogrel group. The number of cases with mild bleeding were 17 in Ticagrelor group(13%) and 3 in Clopidogrel group (2.3%). The incidence of minor bleeding risk in Ticagrelor group was significantly higher than the Clopidogrel group(P<0.01). Conclusion The incidence of minor bleeding risk in Ticagrelor group was higher than Clopidogrel.There was no MACE occurrence and serious bleeding among two groups. We need to pay more attention to this problem in clinical use, and more clinical research should be proposed.