摘要
目的评估终末期肝病血清钠模型(MELD-Na)评分联合血清胆碱酯酶(CHE)水平对预测失代偿期肝硬化预后的价值。方法选择我院失代偿期肝硬化患者70例(存活组49例,死亡组21例),分别计算MELD-Na评分,测定血清CHE水平。分析MELD-Na评分和CHE水平与预后的关系。结果存活组MELD-Na评分明显低于死亡组(P<0.01),CHE明显高于死亡组(P<0.01)。随MELD-Na评分升高CHE降低,且死亡率上升。2项指标与预后的Logistic回归分析均有显著性意义(P<0.01)。MELD-Na评分和CHE与预后的ROC曲线下面积(AUC)分别是0.868和0.878,提示二者在预测肝硬化患者预后时均具有一定的价值,二者无明显差异(P>0.05),而二者联合预测时AUC为0.972,准确性大于其中任何一项单独预测(P<0.05)。结论 MELD-Na评分和CHE水平与失代偿期肝硬化患者预后有重要的相关性,二者联合可明显提高对预后判断的准确性,为临床救治提供一定的指导。
Objective To explore the relationship of MELD-Na score and the changes of CHE concentration with the state of illness and prognosis of patients with decompensate cirrhosis. Methods MELD-Na score was assessed,and the CHE concentration in serum were determined in 70 patients. All patients were divided into two groups based on their prognosis: survival group and death group. The relationships of CHE concentration and MELD-Na score with state of illness and prognosis were analyzed. Results The MELD-Na score in survival group was significantly lower than death group (P〈0.01),while Concentration of serum CHE in survival group significantly higher than death group (P〈0.01). Mortality rate increased with MELD-Na score,while CHE concentration became lower. In the Logistic Regression Analysis of prognosis,both indexes were obviously significant (P〈0.01). Area under curve (AUC) of MELD-Na score and CHE were 0.868 and 0.878,respectively.They both had some value in predicting the prognosis of decompensate cirrhosis patients,but there were no significant differences (P〉0.05). AUC of the joint forecasts was 0.972,the predicting accuracy was higher than any of them (P〈0.05). Conclusion MELD-Na score and serum CHE concentration both had some value in predicting the prognosis of decompensate cirrhosis patients. The joint forecasts could significantly improve the accuracy of prognosis and provide some clinical guidance for treatment.
出处
《中国现代医生》
2011年第6期48-50,共3页
China Modern Doctor