摘要
目的评价Child-Pugh、终末期肝病模型(MELD)及MELD-Na模型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患者短期预后的准确性。结果除去10例非出血原因死亡的患者外,94例患者在随访3个月内有49例(52.13%)再出血;再出血与未再出血患者Child-Pugh、MELD和MELD-Na分值无显著性差异;104例患者在随访3个月内有15例患者死亡,死亡患者MELD-Na(26.6412.50)与生存患者(20.354.54)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,model of end-stage liver disease（MELD）,and the MELD-Na model in the short-term predicting the rebleeding in patients of decompensated liver cirrhosis with esophageal-gastric varices bleeding（EGVB）.Methods The patients were graded with MELD,Child-Pugh and MELD-Na and observed their rebleeding and mortality;The accuracy of the three models on predicting survival were analyzed using the area under the receiver operating characteristic（ROC）curve（AUC）.Results 49 patients（52.13%）had re-bleeding within 3 months;the Child-Pugh,MELD and MELD-Na scores in patients with re-bleeding and non-bleeding were not significantly different;15 patients died within 3 months,whose MELD-Na score（26.6412.50）was higher than those of survivors（20.354.54,P0.001）;In determining the prognosis of patients with ROC curve AUC comparison,Child-Pugh classification（0.703）MELD-Na score（0.661）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 can not predict the short-term rebleeding.
出处
《实用肝脏病杂志》
CAS
2011年第2期129-131,共3页
Journal of Practical Hepatology
