目的探讨白蛋白-胆红素评分对重症胰腺炎患者的预后评估价值。方法选取辽阳市中心医院2017年12月至2020年12月收治的60例重症胰腺炎患者作为重症组,另取同期60例轻度胰腺炎患者作为轻症组,对比两组患者的白蛋白-胆红素评分和急性生理与...目的探讨白蛋白-胆红素评分对重症胰腺炎患者的预后评估价值。方法选取辽阳市中心医院2017年12月至2020年12月收治的60例重症胰腺炎患者作为重症组,另取同期60例轻度胰腺炎患者作为轻症组,对比两组患者的白蛋白-胆红素评分和急性生理与慢性健康(APACHEⅡ)评分,并依照患者的治疗情况,依照患者的预后情况将其分为存活组(n=40)和死亡组(n=20),对比两组患者的临床情况,并分析白蛋白-胆红素评分对重症胰腺炎患者的预后评估价值。结果重症组与轻症组患者白蛋白-胆红素评分[(-2.54±0.42)分VS(-2.86±0.47)分]、APACHEⅡ[(9.24±2.24)分VS(5.12±1.78)分]对比,重症组高于轻症组(P<0.05);存活组与死亡组患者性别、年龄、BMI对比,差异无统计学意义(P>0.05),存活组与死亡组患者前白蛋白[(187.47±40.58)mg/L VS(152.38±33.75)mg/L]、白蛋白[(40.39±4.28)g/L VS(35.81±3.04)g/L]、总胆红素[(13.47±3.84)μmol/L VS(18.02±4.79)μmol/L]、胰腺坏死情况(3/37 VS 8/12)、发生器官衰竭情况(2/38 VS 13/7)、白蛋白-胆红素评分[(-2.87±0.45)分VS(-2.34±0.42)分]、APACHEⅡ评分[(5.08±1.35)分VS(12.43±3.24分)]对比,差异有统计学意义(P<0.05);白蛋白-胆红素评分、APACHEⅡ评分为重症胰腺炎患者的预后不良影响因素(P<0.05)。结论APACHEⅡ与白蛋白-胆红素评分均能够判断急性胰腺炎患者的病情严重程度及预后状况,白蛋白-胆红素评分对重症胰腺炎患者的临床治疗与预后评估具有重要价值。展开更多
BACKGROUND The albumin-bilirubin(ALBI)score was validated as a prognostic indicator in patients with liver disease and hepatocellular carcinoma.Incorporating platelet count in the platelet-albumin-bilirubin(PALBI)scor...BACKGROUND The albumin-bilirubin(ALBI)score was validated as a prognostic indicator in patients with liver disease and hepatocellular carcinoma.Incorporating platelet count in the platelet-albumin-bilirubin(PALBI)score improved validity in predicting outcome of patients undergoing resection and ablation.AIM To evaluate the PALBI score in predicting outcome of acute variceal bleeding in patients with cirrhosis.METHODS The data of 1517 patients with cirrhosis presenting with variceal bleeding were analyzed.Child Turcotte Pugh(CTP)class,Model of End-stage Liver Disease(MELD),ALBI and PALBI scores were calculated on admission,and were correlated to the outcome of variceal bleeding.Areas under the receivingoperator characteristic curve(AUROC)were calculated for survival and rebleeding.RESULTS Mean age was 52.6 years;1176 were male(77.5%),69 CTP-A(4.5%),434 CTP-B(29.2%),1014 CTP-C(66.8%);306 PALBI-1(20.2%),285 PALBI-2(18.8%),and 926 PALBI-3(61.1%).Three hundred and thirty-two patients died during hospitalization(21.9%).Bleeding-related mortality occurred in 11%of CTP-B,28%of CTP-C,in 21.8%of PALBI-2 and 34.4%of PALBI-3 patients.The AUROC for predicting survival of acute variceal bleeding was 0.668,0.689,0.803 and 0.871 for CTP,MELD,ALBI and PALBI scores,respectively.For predicting rebleeding the AUROC was 0.681,0.74,0.766 and 0.794 for CTP,MELD,ALBI and PALBI scores,respectively.CONCLUSION PALBI score on admission is a good prognostic indicator for patients with acute variceal bleeding and predicts early mortality and rebleeding.展开更多
目的研究PALBI联合AMIS65评分系统用于肝硬化急性上消化道出血患者预后评估的临床价值。方法选择2017年9月至2021年3月期间无锡市第五人民医院收治的230例肝硬化合并急性上消化道出血患者。根据入院30 d内生存情况,分为生存组(n=201)和...目的研究PALBI联合AMIS65评分系统用于肝硬化急性上消化道出血患者预后评估的临床价值。方法选择2017年9月至2021年3月期间无锡市第五人民医院收治的230例肝硬化合并急性上消化道出血患者。根据入院30 d内生存情况,分为生存组(n=201)和死亡组(n=29),采集和比较两组患者性别、年龄等流行病学资料和血常规、肝肾功能、凝血功能等血液学指标。比较两组患者PALBI评分和AMIS65评分,通过单因素分析和基于偏最大似然估计前进法logistic回归分析确定死亡的独立影响因素,应用ROC曲线评估PALBI和AMIS65评分单独和联合预测死亡的预测价值。结果死亡组患者凝血酶原时间(21.64±2.97 vs 20.12±2.68,t=2.816,P=0.005)、总胆红素(34.76±2.78 vs 26.87±3.02,t=13.277,P<0.001)、国际标准化比值(1.55±0.21 vs 1.33±0.38,t=4.649,P<0.001)、PALBI评分(-1.43±0.31 vs-1.94±0.26,t=9.629,P<0.001)和AMIS65评分(3.45±0.58 vs 2.09±0.41,t=12.195,P<0.001)明显高于生存组;死亡组患者白蛋白(27.54±6.01 vs 31.98±5.01,t=4.346,P<0.001)、血小板计数(71.99±18.23 vs 83.56±24.25,t=1.829,P=0.049)和Child-Pugh分级A比例(3.45%vs 33.83%,χ^(2)=26.117,P<0.001)明显低于生存组。logistic回归分析显示,PALBI评分(OR=1.597,95%CI:1.597~2.449)和AMIS65评分(OR=2.162,95%CI:1.499~3.357)是肝硬化急性上消化道出血预后的独立影响因素,得到方程为logit(P)=-0.541+0.682XPALBI评分+0.771XAMIS65评分。ROC曲线结果显示,PALBI评分单独预测最佳临界值为-1.69分,对应的灵敏度为79.31%,特异度为80.60%,AUC为0.801(95%CI:0.750~0.852);AMIS65评分单独预测临界值为2.73分,对应的灵敏度为65.52%,特异度为62.69%,AUC为0.760(95%CI:0.707~0.812);回归联合检测最佳截断值对应的灵敏度、特异度和AUC分别为96.55%,95.52%和0.975(95%CI:0.924~0.986),联合预测的灵敏度、特异度和AUC均显著高于PALBI评分和AMIS65评分单独预测(P<0.05),具有一定的预测价值。结论PALBI评分和A展开更多
BACKGROUND Due to the significant shortage of organs and the increasing number of candidates on the transplant waiting list, there is an urgent need to identify patients who are most likely to benefit from liver trans...BACKGROUND Due to the significant shortage of organs and the increasing number of candidates on the transplant waiting list, there is an urgent need to identify patients who are most likely to benefit from liver transplantation. The albuminbilirubin(ALBI) grading system was recently developed to identify patients at risk for adverse outcomes after hepatectomy. However, the value of the pretransplant ALBI score in predicting outcomes after liver transplantation has not been assessed.AIM To retrospectively investigate the value of the pretransplant ALBI score in predicting outcomes after liver transplantation.METHODS The clinical data of 272 consecutive adult patients who received donation after cardiac death and underwent liver transplantation at our centre from March 2012 to March 2017 were analysed in the cohort study. After the exclusion of patients who met any of the exclusion criteria, 258 patients remained. The performance of the ALBI score in predicting overall survival and postoperative complications after liver transplantation was evaluated. The optimal cut-off value of preoperative ALBI was calculated according to long-term survival status. The outcomes after liver transplantation, including postoperative complications and survival analysis, were measured.RESULTS The remaining 258 consecutive patients were included in the analysis. The median follow-up time was 17.30(interquartile range: 8.90-28.98) mo. Death occurred in 35 patients during follow-up. The overall survival rate was 81.0%.The preoperative ALBI score had a significant positive correlation with the overall survival rate after liver transplantation. The calculated cut-off for ALBI scores to predict postoperative survival was-1.48. Patients with an ALBI score >-1.48 had a significantly lower survival rate than those with an ALBI score ≤-1.48(73.7% vs 87.6%, P < 0.05), and there were no statistically significant differences in survival rates between patients with a model for end stage liver disease score ≥ 10 and < 10 and different Child-Pug展开更多
文摘目的探讨白蛋白-胆红素评分对重症胰腺炎患者的预后评估价值。方法选取辽阳市中心医院2017年12月至2020年12月收治的60例重症胰腺炎患者作为重症组,另取同期60例轻度胰腺炎患者作为轻症组,对比两组患者的白蛋白-胆红素评分和急性生理与慢性健康(APACHEⅡ)评分,并依照患者的治疗情况,依照患者的预后情况将其分为存活组(n=40)和死亡组(n=20),对比两组患者的临床情况,并分析白蛋白-胆红素评分对重症胰腺炎患者的预后评估价值。结果重症组与轻症组患者白蛋白-胆红素评分[(-2.54±0.42)分VS(-2.86±0.47)分]、APACHEⅡ[(9.24±2.24)分VS(5.12±1.78)分]对比,重症组高于轻症组(P<0.05);存活组与死亡组患者性别、年龄、BMI对比,差异无统计学意义(P>0.05),存活组与死亡组患者前白蛋白[(187.47±40.58)mg/L VS(152.38±33.75)mg/L]、白蛋白[(40.39±4.28)g/L VS(35.81±3.04)g/L]、总胆红素[(13.47±3.84)μmol/L VS(18.02±4.79)μmol/L]、胰腺坏死情况(3/37 VS 8/12)、发生器官衰竭情况(2/38 VS 13/7)、白蛋白-胆红素评分[(-2.87±0.45)分VS(-2.34±0.42)分]、APACHEⅡ评分[(5.08±1.35)分VS(12.43±3.24分)]对比,差异有统计学意义(P<0.05);白蛋白-胆红素评分、APACHEⅡ评分为重症胰腺炎患者的预后不良影响因素(P<0.05)。结论APACHEⅡ与白蛋白-胆红素评分均能够判断急性胰腺炎患者的病情严重程度及预后状况,白蛋白-胆红素评分对重症胰腺炎患者的临床治疗与预后评估具有重要价值。
文摘BACKGROUND The albumin-bilirubin(ALBI)score was validated as a prognostic indicator in patients with liver disease and hepatocellular carcinoma.Incorporating platelet count in the platelet-albumin-bilirubin(PALBI)score improved validity in predicting outcome of patients undergoing resection and ablation.AIM To evaluate the PALBI score in predicting outcome of acute variceal bleeding in patients with cirrhosis.METHODS The data of 1517 patients with cirrhosis presenting with variceal bleeding were analyzed.Child Turcotte Pugh(CTP)class,Model of End-stage Liver Disease(MELD),ALBI and PALBI scores were calculated on admission,and were correlated to the outcome of variceal bleeding.Areas under the receivingoperator characteristic curve(AUROC)were calculated for survival and rebleeding.RESULTS Mean age was 52.6 years;1176 were male(77.5%),69 CTP-A(4.5%),434 CTP-B(29.2%),1014 CTP-C(66.8%);306 PALBI-1(20.2%),285 PALBI-2(18.8%),and 926 PALBI-3(61.1%).Three hundred and thirty-two patients died during hospitalization(21.9%).Bleeding-related mortality occurred in 11%of CTP-B,28%of CTP-C,in 21.8%of PALBI-2 and 34.4%of PALBI-3 patients.The AUROC for predicting survival of acute variceal bleeding was 0.668,0.689,0.803 and 0.871 for CTP,MELD,ALBI and PALBI scores,respectively.For predicting rebleeding the AUROC was 0.681,0.74,0.766 and 0.794 for CTP,MELD,ALBI and PALBI scores,respectively.CONCLUSION PALBI score on admission is a good prognostic indicator for patients with acute variceal bleeding and predicts early mortality and rebleeding.
文摘目的研究PALBI联合AMIS65评分系统用于肝硬化急性上消化道出血患者预后评估的临床价值。方法选择2017年9月至2021年3月期间无锡市第五人民医院收治的230例肝硬化合并急性上消化道出血患者。根据入院30 d内生存情况,分为生存组(n=201)和死亡组(n=29),采集和比较两组患者性别、年龄等流行病学资料和血常规、肝肾功能、凝血功能等血液学指标。比较两组患者PALBI评分和AMIS65评分,通过单因素分析和基于偏最大似然估计前进法logistic回归分析确定死亡的独立影响因素,应用ROC曲线评估PALBI和AMIS65评分单独和联合预测死亡的预测价值。结果死亡组患者凝血酶原时间(21.64±2.97 vs 20.12±2.68,t=2.816,P=0.005)、总胆红素(34.76±2.78 vs 26.87±3.02,t=13.277,P<0.001)、国际标准化比值(1.55±0.21 vs 1.33±0.38,t=4.649,P<0.001)、PALBI评分(-1.43±0.31 vs-1.94±0.26,t=9.629,P<0.001)和AMIS65评分(3.45±0.58 vs 2.09±0.41,t=12.195,P<0.001)明显高于生存组;死亡组患者白蛋白(27.54±6.01 vs 31.98±5.01,t=4.346,P<0.001)、血小板计数(71.99±18.23 vs 83.56±24.25,t=1.829,P=0.049)和Child-Pugh分级A比例(3.45%vs 33.83%,χ^(2)=26.117,P<0.001)明显低于生存组。logistic回归分析显示,PALBI评分(OR=1.597,95%CI:1.597~2.449)和AMIS65评分(OR=2.162,95%CI:1.499~3.357)是肝硬化急性上消化道出血预后的独立影响因素,得到方程为logit(P)=-0.541+0.682XPALBI评分+0.771XAMIS65评分。ROC曲线结果显示,PALBI评分单独预测最佳临界值为-1.69分,对应的灵敏度为79.31%,特异度为80.60%,AUC为0.801(95%CI:0.750~0.852);AMIS65评分单独预测临界值为2.73分,对应的灵敏度为65.52%,特异度为62.69%,AUC为0.760(95%CI:0.707~0.812);回归联合检测最佳截断值对应的灵敏度、特异度和AUC分别为96.55%,95.52%和0.975(95%CI:0.924~0.986),联合预测的灵敏度、特异度和AUC均显著高于PALBI评分和AMIS65评分单独预测(P<0.05),具有一定的预测价值。结论PALBI评分和A
基金Supported by the Ministry of Education Innovation Team Development Program of China,No.IRT16R57the National Natural Science Foundation of China,No.81470896Research Fund for the Young Talent Recruiting Plans of Xi’an Jiaotong University(RW)
文摘BACKGROUND Due to the significant shortage of organs and the increasing number of candidates on the transplant waiting list, there is an urgent need to identify patients who are most likely to benefit from liver transplantation. The albuminbilirubin(ALBI) grading system was recently developed to identify patients at risk for adverse outcomes after hepatectomy. However, the value of the pretransplant ALBI score in predicting outcomes after liver transplantation has not been assessed.AIM To retrospectively investigate the value of the pretransplant ALBI score in predicting outcomes after liver transplantation.METHODS The clinical data of 272 consecutive adult patients who received donation after cardiac death and underwent liver transplantation at our centre from March 2012 to March 2017 were analysed in the cohort study. After the exclusion of patients who met any of the exclusion criteria, 258 patients remained. The performance of the ALBI score in predicting overall survival and postoperative complications after liver transplantation was evaluated. The optimal cut-off value of preoperative ALBI was calculated according to long-term survival status. The outcomes after liver transplantation, including postoperative complications and survival analysis, were measured.RESULTS The remaining 258 consecutive patients were included in the analysis. The median follow-up time was 17.30(interquartile range: 8.90-28.98) mo. Death occurred in 35 patients during follow-up. The overall survival rate was 81.0%.The preoperative ALBI score had a significant positive correlation with the overall survival rate after liver transplantation. The calculated cut-off for ALBI scores to predict postoperative survival was-1.48. Patients with an ALBI score >-1.48 had a significantly lower survival rate than those with an ALBI score ≤-1.48(73.7% vs 87.6%, P < 0.05), and there were no statistically significant differences in survival rates between patients with a model for end stage liver disease score ≥ 10 and < 10 and different Child-Pug
