摘要
目的:评价终末期肝病模型(MELD)在评估我国肝硬化患者预后方面的作用.方法:选择具有完整临床资料和随访结果的216例肝硬化患者进行回顾性分析.利用受试者工作特征曲线(ROC)及其下面积(AUC)比较MELD、美国器官共享网络(UNOS)修改后的MELD(U-MELDl、Child-Turcotte- Pugh(CTP)评分及分级判断预后的能力.每位患者的MELD值根据Kamath修改后的公式计算,U-MELD值根据UNOS修改后的计算方法计算.AUC的比较采用非参数方法.结果:MELD在判断患者3,6 mo,1a等生存时间的ROC曲线AUC值分别是0.838.0.856.0.877,均大于CTP评分及分级的AUC值.与CTP分级有显著性差异,但与CTP评分无显著性差异.U-MELD在判断3mo预后时的AUC值与CTP评分的差异有统计学意义(P=0.028),而在6mo,1a时两者间的AUC差异尚无统计学意义.结论:MELD与CTP评分的差异无统计学意义,而U-MELD在评估3mo预后方面较CTP评分已有显著优势.
AIM: To evaluate the capability of the model for end-stage liver disease (MELD) in predicting the prognosis of Chinese patients with liver cirrhosis.
METHODS: A cohort of 216 patients with liver cirrhosis were retrospectively studied and followed up. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare MELD, U-MELD (MELD modified by the United Network for Organ Sharing), Child- Turcotte-Pugh (CTP) score and classification in predicting accuracy. MELD score was obtained for each patient according to the modified formula by Kamath. U-MELD score was obtained according to the modified formula by the United Network for Organ Sharing (UNOS). Nonparametric approach was applied for the comparison of AUC.
RESULTS: The AUC value generated by the ROC curve for MELD was 0.838 at 3 mo, 0.856 at 6 mo and 0.877 at 1 year. MELD was better than CTP classification, and there was significant difference between them. However, there was no significant difference between MELD and CTP score. U-MELD was more accurate than CTP score in predicting the 3-mo prognosis (P = 0.028), while it did not show significant superiority in predicting 6-mo and 1-year prognosis. CONCLUSION: There is no significant difference between MELD and CTP score, but U-MELD is superior to CTP score in predicting the 3-mo prognosis.
出处
《世界华人消化杂志》
CAS
北大核心
2006年第29期2889-2892,共4页
World Chinese Journal of Digestology
关键词
肝硬化
预后
模型
Liver cirrhosis
Prognosis
Model