摘要
乙型肝炎目前仍是世界性健康问题，其相关终末期疾病病死率高。肝硬化的预后模型中仍以终末期肝病模型、Child-Pugh应用广泛，炎症反应、B型尿钠肽、门静脉血栓为独立危险因素；肝衰竭预后中提出了新模型，其中以HINATACLF为佳，单因素中增加了中性粒细胞／淋巴细胞比率、促甲状腺素、胆碱酯酶、抗病毒治疗的应答情况。肝癌发生的预测模型中多涉及HBVDNA，但随着抗病毒药物的普及，其在长期预后中的价值逐渐降低，因此以肝硬度值取代HBVDNA的修正慢性乙型肝炎肝细胞癌的风险评估表现出明显优势；在肝癌患者的预后中，白蛋白-胆红素指数有良好的中位生存期预测价值，甲胎蛋白、肝癌数目及大小仍为独立危险因素。
Hepatitis B remains a worldwide health problem with a high mortality rate associated with end-stage liver diseases. The Model for End-Stage Liver Disease and Child-Pugh score is still widely used as the prognostic model for liver cirrhosis and inflammatory reaction, B-type natriuretic peptide and portal vein thrombosis are independent risk factors. Many new models have been proposed for liver faihire, including a new model HINAT ACLF. HINAT ACLF is better than its preceding models and increased neutrophil-to-lymphocyte ratio is a single factor to promote thyroid hormone, cholinesterase, and antiviml treatment response in this model. HBV DNA is frequently involved in the predictive model of liver cancer, but with widespread use of antiviral drugs, the value of its long-term prognostication has gradually reduced. Therefore, liver stiffness value instead of HBV DNA shows apparent advantages in mREACH-B. ALBI has good median survival prediction value for hepatocellular carcinoma patients. Alpha-fetoprotein and staging method, which is based on tumor number and size, are still independent risk factors for liver cancer.
作者
冯雪
石小枫
Feng Xue;Shi Xiaofeng(Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2018年第8期626-629,共4页
Chinese Journal of Hepatology
关键词
肝炎
乙型
肝硬化
肝功能衰竭
癌
肝细胞
预后预测
Hepatitis B virus
Cirrhosis
Liver failure
Carcinoma
hepatocellular
Prognosis
