摘要
目的评价Child-Pugh、终末期肝病模型(MELD)、及MELD-Na评分对肝硬化食管胃底静脉曲张出血患者短期再出血及预后的预测价值。方法分别计算104例肝硬化食管胃底静脉曲张出血患者的Child-Pugh、MELD及MELD-Na分值,并随访其再出血及死亡。运用ROC曲线及曲线下面积(AUC)比较三种评分系统判断肝硬化食管胃底静脉曲张出血患者短期预后的准确性。结果 94例患者随访3个月内有49例再出血,再出血组与未出血组在Child-Pugh、MELD及MELD-Na分值上差异无统计学意义;104例患者随访3个月内有15例死亡,死亡组MELD-Na评分(26.64±12.50)与生存组(20.35±4.54)比较差异有统计学意义(P<0.001);在判断患者预后的ROC曲线AUC比较中,Child-Pugh分级(0.703)>MELD-Na评分(0.661)>MELD评分(0.627)。结论 Child-Pugh、MELD和MELD-Na评分均可有效地预测肝硬化食管胃底静脉曲张出血患者的短期预后,但不能有效预测短期再出血。
Objective To evaluate the clinical value of Child-Pugh,end-stage liver disease（MELD）,and the MELD-Na model in the prediction of rebleeding and short-term prognosis of decompensated liver cirrhosis patients with EGVB.Methods The patients were graded with MELD,Child-Pugh and MELD-Na scores,by rebleeding and mortality of these patients were recorded;The accuracy of the three parameters were analyzed by using the area under the receiver operating characteristic（ROC） curve（AUC）.Results Forty-nine patients developed re-bleeding in 3 months.between re-bleeding group and the non-bleeding group No significant difference was observed in the score of Child-Pugh,MELD and MELD-Na;Fifteen patients died within 3 months,whose MELD-Na score（26.64±12.50） were higher than those of survivors（20.35±4.54,P〈0.001）;In determining the prognosis of patients with ROC curve AUC comparison,Child-Pugh classification（0.703） was superior to MELD-Na score（0.661） and MELD score（0.627）.Conclusion Child-Pugh score,MELD score and MELD-Na score can effectively predict the short-term prognosis of patients with decompensated liver cirrhosis,but failed to predict the short-term rebleeding.
出处
《肝脏》
2011年第1期20-22,共3页
Chinese Hepatology
