摘要
目的探讨影响HBV相关性慢加急性肝衰竭(HBV-ACLF)患者短期生存预后的危险因素并建立预后模型。方法收集72例HBV-ACLF患者临床资料,根据90 d生存情况分为生存组(33例)和死亡组(39例),采用logistic回归分析危险因素,并构建预后预测模型。结果死亡组年龄、中性粒/淋巴细胞比值及血清谷丙转氨酶、总胆红素、乳酸、C反应蛋白、C反应蛋白/白蛋白比值、胱抑素C、D-二聚体水平均显著高于生存组,而Na+、凝血酶原活动度显著低于生存组。血清总胆红素、胱抑素C、乳酸及D-二聚体是不良预后的独立危险因素。ROC曲线提示,TCLD模型的诊断效能优于终末期肝病模型。结论TCLD模型对HBV-ACLF患者90 d预后具有较好预测价值。
Objective To investigate the risk factors for short-term survival and establish a prognostic model in HBV associated acute on chronic liver failure(HBV-ACLF).Methods Clinical data of 72 patients with HBV-ACLF were collected and divided into death(n=39)and survival groups(n=33)according to 90-day survival.The risk factors were analyzed by logistic regression,and a prognostic model was constructed.Results Compared with survival group,age,neutrophil//lymphocyte ratio,and serum levels of alanine transaminase,total bilirubin(TBIL),lactic acid(LA),C-reactive protein,C-reactive protein/albumin ratio,cystatin C(CysC),and D-dimer were higher,while Na+and prothrombin activity were lower in death group.TBIL,CysC,LA and D-dimer were independent risk factors for poor prognosis.The ROC curve indicated that the diagnostic efficiency of TCLD model was superior to that of Model for End Stage Liver Disease(MELD).Conclusion TCLD model could be effective for predicting 90-day prognosis of HBV-ACLF patients.
作者
巴志伟
詹步同
刘传苗
BA Zhi-wei;ZHAN Bu-tong;LIU Chuan-miao(First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《广东医科大学学报》
2022年第1期70-74,共5页
Journal of Guangdong Medical University
关键词
慢加急性肝衰竭
危险因素
预后
acute-on-chronic liver failure
risk factor
prognosis
