摘要
目的:探究酒精性肝硬化(ALC)患者血脂水平与Child-Pugh分级之间的关系。方法:选取2020年8月至2022年2月在首都医科大学附属北京地坛医院住院的ALC患者348例,其中Child-Pugh A+B级患者共有245例,Child-Pugh C级患者103例,记录患者的性别、年龄、实验室指标;通过单因素和多因素二元Logistic回归得出判断Child-Pugh C级的独立危险因素;绘制受试者工作特征曲线(ROC),得出曲线下面积(AUC)来评估诊断价值,并根据约登指数计算cut-off值。结果:与Child-Pugh A+B级患者相比,Child-Pugh C级患者WBC、AST、TBil、PT、INR水平都显著高于前者,而RBC、Hgb、PLT、Alb均低于前者;TC、TG、HDL-C、LDL-C水平低于前者,尤其是HDL-C水平降低更为明显。以所属的Child-Pugh等级作为因变量,通过单因素和多因素Logistic回归显示,年龄(OR=0.932,95%CI=0.899~0.966,P<0.001),WBC(OR=1.196,95%CI=1.053~1.360,P=0.006),PLT(OR=0.989,95%CI=0.982~0.995,P=0.001),CHE(OR=0.999,95%CI=0.998~0.999,P<0.001),HDL-C(OR=0.252,95%CI=0.082~0.779,P=0.017)是Child-Pugh C级的独立危险因素。进一步绘制HDL-C的ROC曲线,得出AUC为0.783,显著高于TC、TG、LDL-C的AUC,分别为0.611、0.550、0.623,显示了HDL-C较好的诊断价值;并根据约登指数得出HDL-C的cut-off值是0.645 mmol/L。结论:ALC患者的HDL-C水平对Child-Pugh分级有一定的参考价值。
Objective:The aim of the study was to investigate the relationship between lipid levels and Child-Pugh classification in patients with Alcoholic Liver Cirrhosis(ALC).Methods:This retrospective study enrolled 348 patients with ALC who were hospitalized in Beijing Ditan Hospital of Capital Medical University between August 2020 and February 2022,including 245 patients with Child-Pugh grade A+B,and 103 patients with Child-Pugh grade C.Gender,age,and laboratory indexes of the patients were recorded;univariate and multifactorial binary logistic regression were employed to identify independent risk factors for determining Child-Pugh classification.The efficacy of these factors was evaluated through receiver operating characteristic curve(ROC).The area under the curve(AUC)was derived to assess the diagnostic value,and the best cut-off value was calculated based on the Yordon index.Results:Compared with Child-Pugh A+B grade patients,WBC,AST,TBil,PT,and INR levels were significantly higher in Child-Pugh class C patients,while RBC,HGB,PLT,and Alb were lower than the former;TC,TG,HDL-C,and LDL-C levels were lower than the former,especially HDL-C levels were much lower than the previous ones.Through univariate and multivariate logistic regression,age(OR=0.932,95%CI:0.899-0.966,P<0.001),WBC(OR=1.196,95%CI:1.053-1.360,P=0.006),PLT(OR=0.989,95%CI:0.982-0.995,P=0.001),CHE(OR=0.999,95%CI:0.998-0.999,P<0.001),and HDL-C(OR=0.252,95%CI:0.082-0.779,P=0.017)were independent risk factors for the diagnosis of liver function in patients with ALC Child Pugh class C.The AUC of HDL-C was 0.783,which was significantly higher than the AUC of TC(0.661),TG(0.550),and LDL-C(0.623),indicating the better diagnostic value of HDL-C.The cut-off value of HDL-C was 0.645 mmol/L based on the Yorden index.Conclusion:HDL-C levels in ALC patients have certain reference value for Child-Pugh grading.
作者
熊飞翔
孟培培
江宇泳
张琴
姜艳丹
段浩鑫
赵赛赛
XIONG Fei-xiang;MENG Pei-pei;JIANG Yu-yong(Department of Integrative Medicine,Beijing Ditan Hospital,Capital Medical University,Beijing,100015,China)
出处
《中西医结合肝病杂志》
CAS
2024年第2期119-122,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
首都卫生科研发展专项(No.2020-2-2172)
国家中医药管理局中医肝病重点专科建设项目。
