摘要
目的比较终末期肝病模型(MELD)评分、Child-Turcotte-Pugh(CTP)评分、MESO指数和MELD-Na评分系统预测慢性重型肝炎患者预后的价值。方法回顾性分析156例慢性重型肝炎患者的临床资料,计算患者入院时的MELD、CTP、MESO和MELD-Na评分。所有患者均随访1年。绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),应用正态Z检验对四者曲线下面积进行比较。结果 156例慢性重型肝炎患者随访1年后有62例患者死亡,死亡组患者MELD、CTP、MESO和MELD-Na评分分别为31.2±6.51、2.4±1.3、2.4±0.6和39.4±9.8,均高于生存组患者(20.2±7.4、10.1±1.5、1.5±0.6和22.5±8.6),差异具有统计学意义(t=6.71t,=7.20t,=8.14t,=9.65,均P<0.01)。各评分系统的AUC分别为0.824、0.6750、.826和0.898;MELD-Na评分系统对慢性重型肝炎预后评估价值显著优于MELD、CTP和MESO(均P<0.01)。结论 MELD-Na是判断慢性重型肝炎患者预后的一个较好的指标,其准确性优于MELD、CTP评分和MESO指数。
Objective To compare the predictive values of four prognostic systems including model for end stage liver disease（MELD）,Child-Turcotte-Pugh（CTP）,MESO and MELD-Na scoring systems in predicting the prognosis of patients with chronic severe hepatitis.Methods A cohort of 156 patients with chronic severe hepatitis were retrospectively studied and followed-up for one year.MELD,CTP,MESO and MELD-Na scores were calculated at the day of admission.Receiver operating characteristics curves（ROC）and the area under ROC（AUC） were used to determine the ability of four systems for predicting the prognosis of patients with severe hepatitis.Results The sores in dead group evaluated by MELD,CTP,MESO and MELD-Na scoring systems（31.2±6.5,12.4±1.3,2.4±0.6,and 39.4±9.8,respectively） were higher than those in survival group（20.2±7.4,10.1±1.5,1.5±0.6,and 22.5±8.6,respectively,P0.01）;The values of AUC of these four systems were 0.824,0.675,0.826,and 0.898,respectively.Conclusion MELD-Na system is a useful prognostic indicator for patients with chronic severe hepatitis.The MELD-Na is superior to MELS,CTP and MESO systems.
出处
《实用肝脏病杂志》
CAS
2011年第2期119-120,126,共3页
Journal of Practical Hepatology
关键词
重型肝炎
预后
生存分析
危险性评估
Severe hepatitis
Prognosis
Survival analysis
Risk assessment
