摘要
目的比较低钠血症、Child-Pugh评分、终末期肝病模型(MELD)评分对失代偿期肝硬化患者近期死亡危险的预测价值。方法选取2000—2009年收住我院的失代偿期肝硬化患者61例,其中19例死亡病例(死亡组),42例好转出院病例(存活组)。比较存活组与死亡组患者血清钠、总胆红素、肌酐水平,凝血酶原时间,MELD评分、Child-Pugh评分等,并对相关数据进行统计分析。结果死亡组患者血清总胆红素、肌酐水平,凝血酶原时间,MELD评分及Child-Pugh评分较存活组显著增高,而血清钠则较存活组显著降低,差异均有统计学意义(P<0.05)。低钠血症与MELD评分、Child-Pugh评分均呈负相关(r值分别为-0.527和-0.419,P均<0.01),MELD评分与Child-Pugh评分呈正相关(r=0.754,P<0.01)。COX回归分析显示,低钠血症及MELD评分是失代偿期肝硬化患者死亡危险性的独立预测因素(P值分别为0.000和0.015)。结论低钠血症与MELD评分均是预测失代偿期肝硬化患者死亡的独立危险因素。
Objective To explore the value of hyponatremia in predicting the outcomes of patients with decompensated cirrhosis. Methods Totally 61 patients with decompensated cirrhosis who were treated in our hospital from 2000 to 2009 were enrolled in this study.Based on their outcomes,they were divided into death group（n=19） and survival group（n=42）.The serum levels of sodium,total bilirubin,and creatinine,prothrombin time,MELD score,and Child-Pugh score were analyzed and compared between these two groups. Results Compared with the survival group,the serum levels of total bilirubin and creatinine,prothrombin time,MELD score,and Child-Pugh score were significantly higher in death group,while the serum sodium level significantly decreased（P0.05）.The hyponatremia showed significant negative correlations with Child-Pugh score and MELD score（r=-0.527,P0.01;r=-0.419,P0.01）.MELD score showed significant positive correlations with Child-Pugh score（r=0.754,P0.01）.COX regression analysis showed both hyponatremia and MELD score were the independent predictors of death among decompensated cirrhotic patients（P=0.000,P=0.015）. Conclusion Hyponatremia is a good parameter for predicting the prognosis of decompensated cirrhotic patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第9期940-942,共3页
Chinese General Practice
