7种肝硬化肝功能评估方法的应用对比

ASSESSMANT OF SEVEN CLASSIFICATIONS IN LIVER FUNCTIONAL STATE IN CIRRHOSIS OF THE LIVER

目的选择适应于临床的肝硬化的肝功能评估方法。方法应用７种以Ｃｈｉｌｄ分类为基础的肝功能评估方法，对３７例乙肝肝硬化患者病历资料进行评估。结果①在７种方法间，Ｃｈｉｌｄ－Ｐｕｇｈ分类（ＣＰＣ）、肝功能不全分类（肝脏，ＬＦＳ），Ａａｒｌｅｙ，Ｔｅｒｂｌａｎｃｈｅ４法之间差异均无显著性；Ｃｈｉｌｄ与门脉法（ＰＶＰ）间差异不显著，而与ＣＰＣ间差异显著；预后指数（ＰＩ）法与余６法间比较差异均有显著性。②若以ＣＰＣ法为标准，据积分结果可见Ｃｈｉｌｄ法、门脉法似较“严格”、ＰＩ法较“乐观”，余４法居中且结果相近。③分析各法对死亡与存活病例的评价，各法间差异均有显著性。结论对肝硬化患者进行肝功能评估，以肝脏、Ｃｈｉｌｄ，ＣＰＣ，Ｈａｒｌｅｙ，Ｔｅｒｂｌａｎｃｈｅ等５法结合评定结果较为满意，但过于复杂。

Objective Checking one method about liver functional stato in cirrhosis for general clinic.Method By using child (Child' classification)as reference,applying the clinical materials of 37 cases of posthepatitis cirrhosis to seven classifications.Result ①Categorizing cases into different classifications;there was no significant difference among CPC (Child Pugh's classification),LFS,Harley and Terblanche;no difference between Child and PVP but marked difference between these two and CPC;marked difference between PI and other six classifications.②If using CPC as standard and correlating the rest six methods with this standard,Child and PVP seems to be more “strict”,PI more loose and “optimistic”,with the rest 4 lying between these two.③Correlating survival and death to the grading of different method,inconsistency was apparent and not every death was categorized into severe grade of dysfunction in eath classification.Conclusion Combinned use of Child,CPC,Harley,Terblanche and LFS seems giving better idea about liver functional state in cirrhosis but it is too copplicated.An ideal one needs further exploration.