终末期肝病模型联合总胆汁酸对亚急性肝衰竭患者预后的评估

The prognostic assessment of model for end-stage liver disease(MELD) and total bile acids in patients with subacute liver failure

目的探讨终末期肝病模型(MELD)联合血清总胆汁酸(TBA)的检测对于判断亚急性肝衰竭患者预后的意义。方法亚急性肝衰竭患者110例,测定血清肌酐(CR),TBil,凝血酶原时间国际标准化比值(INR),TBA,根据公式计算MELD值,单一评估MELD,TBA及二者联合对亚急性肝衰竭患者预后的判断价值。结果恶化死亡组的MELD值及TBA均明显高于好转治愈组(P<0.05),MELD值、TBA值各组间病死率的比较具有统计学意义(P<0.01)。将MELD值≥30,TBA值≥200联合判断患者病死率的敏感性和特异性分别为67.65%,97.37%,MELD值与TBA值呈正相关(r=0.9903,P<0.01)。结论 MELD分值联合TBA可以提高亚急性肝衰竭患者预后判断的准确性。

Objective To analyze the effect of combination of MELD with total bile acids on predicting the prognosis of subacute liver failure.Methods Serum CR,INR,TBil and TBA of 81 patients with subacute liver failure were detected and MELD scores were calculated by the formula.The single scores of MELD or total bile acids and the two kinds of scores together were compared.Results The level of MELD and total bile acids of patients in death group were higher than that in survival group（P〈0.05）.There were significant differences in the mortality of the MELD and serum TBA in respective groups（P〈0.01）.Predicting the death prognosis with MELD≥30 and TBA≥200,the sensitivity and the specificity can reach 67.65℅ and 97.37℅ respectively.There was a positive correlation between serum TBA and MELD（r=09903,P〈0.01）.Conclusion MELD and total bile acids improves the accuracy of prognosis for patients with subacute liver failure