终末期肝病模型对肝硬化失代偿期患者预后的预测价值

郑晓丽; 汪良芝; 吴宝利

终末期肝病模型对肝硬化失代偿期患者预后的预测价值

苏州大学附属第三医院消化内科

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中图分类号: R575.2
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出版历程
- 出版日期: 2011-07-20

Value of model for end-stage liver disease in prediction of prognosis in patients with decompensated hepatic cirrhosis

摘要

摘要: 目的评估终末期肝病模型（MELD）、终末期肝病模型联合Na评分（MELD-Na）、终末期肝病模型评分/血钠比值（MESO指数）、Child-Pugh（CTP）分值对失代偿期肝硬化患者预后的预测价值。方法对140例失代偿期肝硬化患者进行回顾性分析,分别比较3、6及12个月内死亡组和存活组之间的MELD评分、MELD-Na评分、MESO指数及CTP分值,并用受试者工作曲线（ROC）及曲线下面积（AUC）比较MELD、MELD-Na评分、MESO指数和CTP分值判断肝硬化患者预后的准确性并获取最佳临界值。结果在随访的3、6及12个月内死亡组和存活组MELD、MELD-Na、MESO及CTP评分比较有显著差异,在判断患者3、6及12个月生存率的ROC曲线AUC比较中,MELD-Na评分与MESO指数、MELD评分及CTP分值比较具有统计学意义差异（P<0.05）,而MELD评分与Child-Pugh分值比较差异无统计学意义（P>0.05）。结论 MELD-Na评分、MESO、MELD及CTP均能较好预测肝硬化失代偿期患者预后,其中MELD-Na仍是以上预测失代偿期肝硬化预后中最具优...
- 肝硬化 /
- 终末期肝病模型 /
- 预后
Abstract: Objective To evaluate the prognostic value of the model for end-stage liver disease (MELD) , MELD-Na scoring system (MELD-Na) , MELD to serum sodium ratio (MESO) index and Child-Pugh grading for patients with decompensated hepatic cirrhosis.Methods One-hundred and forty decompenstated liver cirrhotic patients were retrospectively analyzed and MELD score, MELD-Na score, MESO index and CTP score was compared between the death and survival groups at 3, 6 and 12 months.The accuracy of the four parameters in predetermining the prognosis were analyzed by using the receiver operating characteristic (ROC) curve and the area under ROC (AUC) .The optimal threshold was calculated by ROC curves.Results During follow-up, at 3, 6 and 12 months, MELD, MELD-Na, MESO and CTP score were significantly different between death group and survival group.There were significant differences of the AUC value generated by the ROC curves among MELD-Na scoring, MESO index, MELD scoring and CTP scoring (P<0.05) , but there was no significant difference between MELD scoring and CTP scoring (P>0.05) .Conclusion MELD-Na scoring, MESO index, MELD scoring sysytem and CTP scoring can predict the prognosis of decompensated hepatic cirrhosis, in which the MELD-Na scoring system is the best.
- liver cirrhosis /
- model for end-stage liver disease /
- prognosis

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参考文献(13)

[1]吕晓辉, 王炳元.终末期肝病模型对失代偿期肝硬化患者预后的回顾性分析[J].世界华人消化杂志, 2007, 15 (9) :960-963.

[2]白平平, 朴云锋, 秦俊杰.终末期肝病模型及Child-Pugh分级对肝硬化患者的短期预后分析[J].临床肝胆病杂志, 2007, 23 (3) :193-194.

[3]HUO TI, Wang YW, Yang YY, et al.Model for end-stage liverdisease score to serum sodiam ratio index as a prognosticpredicter and its correlation with portal pressure in patients withliver cirrhosis[J].Lever Int, 2007, 27 (4) :498-506.

[4]中华医学会.病毒性肝炎防治方案[J].中华肝脏病杂志, 2000, 8 (6) :324-329.

[5]张玉, 屈小勤.MELD评分系统对乙型肝炎后肝硬化失代偿期患者预后预测的应用价值[J].现代实用医学, 2010, 1 (22) :32-33.

[6]Biggins SW, Kim WR, Terrault NA, et al.Evidence basedin corporation of serum sodium cincentration into MEID[J].Gastroenterology, 2006, 130 (6) :1652-1660.

[7]Kamath PS, Wiesner RH, Malinchic M, et al.A model to predictsurvival in patients with end stage liver disease[J].Hepatology, 2001, 33 (2) :464-470.

[8]Wang VW, Chim AM, Wong GL, et al.Performance of the newMELD-Na score in predicting 3-month mortality in Chinesepatients with chronic hepatitis[J].Liver Transpl, 2007, 13 (9) :1228-1335.

[9]王文虎, 王鲁文.肝硬化腹水患者低钠血症与病情严重程度的关系[J].临床内科杂志, 2007, 24 (9) :636-638.

[10]Heuman DM, Abou-Assi SG, Habib A, et al.Persistence ascitesand low serum sodium identify patients with cirrhosis and lowMELD scores who are at high risk for early death[J].Hepatology, 2004, 40 (4) :802-810.

[11]孔心涓, 姜英俊, 武军, 等.终末期肝病模型评估失代偿期肝硬化患者预后的价值[J].世界华人消化杂志, 2009, 17 (17) :1786-1790.

[12]毕春山, 展玉涛.终末期肝病模型联合血清钠预测肝硬化预后研究[J].山东医药, 2008, 48 (19) :9-10.

[13]Wong VW, Chim AM, Wong GL, et al.Performance of the newMELD-Na score in predicting 3-month and 1-year mortality inChinese patients with chronic hepatitis B[J].Liver Tranpl, 2007, 13 (9) :1228-1235.

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