摘要
目的:比较终末期肝病模型(MELD)、MELD与血清钠比值(MESO)及Child-Pugh分级(CTP)对失代偿期肝硬化患者短期生存率的预测能力.方法:256例失代偿期肝硬化患者,按MELD模型、MESO及Child-Pugh分级评分;应用ROC曲线评价每一预测模型对于失代偿期肝硬化患者短期生存率的预测结果.结果:预测患者lmo及3mo内的病死率,MESO及MELD明显优于CTP评分(1mo:0.866,0.819vs0.722;3mo:0.875,0.820vs0.721,均P<0.01);在低MELD组,MESO及CTP明显优于MELD评分,差异显著(0.758,0.759;0.754,0.732vs0.608,0.611;P<0.01).然而在高MELD组,MESO及MELD优于CTP评分,但无显著性差异(0.762,0.779;0.737,0.773vs0.710,0.752,P>0.05).结论:MESO评分系统,由于同时考虑了MELD及血清钠(sNa),其对失代偿期肝硬化患者预后评估能力优于MELD及CTP评分系统.
AIM：To compare the accuracy of model for end-stage liver disease（MELD） to serum sodium（SNa） ratio（MESO） with MELD score and modified Child-Turcotte-Pugh（CTP） score for predicting the short-term survival of cirrhotic patients.METHODS：The data for 256 patients with cirrhosis were analyzed using a cohort method.The patients were graded based on MELD score into two groups（MELD ≤ 17 and MELD 17）.The area under the receiver operating characteristic curve（AUC） was used to compare the predictive accuracy of MESO index,MELD score and modified CTP score.RESULTS：Overall,MESO index and MELD score were significantly better than CTP score in predicting the risk of mortality at 1 mo（0.866 and 0.819 vs 0.722,both P〈 0.01） and 3 mo（0.875 and 0.820 vs 0.721,both P 〈0.01）.In the lowMELD group,the AUC of MESO index and CTP was significantly higher than that of MELD score at 1 mo and 3 mo（0.758,0.759;0.754,0.732 vs 0.608,0.611,all P〈 0.01）.However,in the high-MELD group,the AUC of MESO index and MELD score was higher than that of CTP score at 1 mo and 3 mo though there were no significant differences（0.762,0.779;0.737,0.773 vs 0.710,0.752,all P 〉0.05）.CONCLUSION：MESO index is superior to MELD score and modified CTP score in the prediction of the short-term survival of patients with cirrhosis.
出处
《世界华人消化杂志》
CAS
北大核心
2010年第29期3084-3088,共5页
World Chinese Journal of Digestology
基金
国家"十五科技攻关"基金资助项目
No
20003BA753C~~
