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势的评分模型。
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.
出处
《临床肝胆病杂志》
CAS
2011年第7期738-740,745,共4页
Journal of Clinical Hepatology
关键词
肝硬化
终末期肝病模型
预后
liver cirrhosis
model for end-stage liver disease
prognosis
