肝移植影响因素的Cox比例风险模型分析

Cox proportional risk model analysis on the affecting factors of liver transplantation

目的 分析影响肝移植生存时间的相关因素 ,找出影响受体肝体移植术后生存时间的主要因素 ,为临床肝移植术提供参考依据。 方法 将手术后受体中资料完整的 116例术前状况、肝功能及术中资料 ,按Cox比例风险模型各指标量化 ,在ASA6 12软件中进行Cox回归和逐步回归分析 ,对 16组变量进行计算。 结果 Z14(FFP)在α =0 0 5水平显著 ,剔除模型中不显著因子 ,回归系数为 0 0 6 5 ,标准误 0 0 2 4,Wald值 7 493,P =0 0 0 6 ,RR =1 0 6 7,活体供肝肝移植和尸体供肝移植术的生存时间没有统计差异 ,但尸体供肝移植相对危险度是活体供肝肝移植的 0 34 0倍。 结论 活体肝移植的开展缩短了受体等待肝移植的时间 ,早期解除了患者痛苦 ,不但适用于小儿 ,亦适用于成人 ,并且为择期肝移植提供了物质保证。

Objective To analyze the relative factors affecting the survival time of liver transplantation and identify the main factors for the purpose of supply the reference evidence to the clinic. Methods The clinical data on preoperative condition, interoperation and liver function in 116 out of 128 recipients were quantified by the cox proportional risk model after liver transplantation. Their variables were calculated and analyzed by cox regression under the SAS 6 12 software. Results Z14 (FFP) was obvious at α=0 05. After deleting the non obvious factors from the model, regression coefficient, standard errors, wald, P and RR were 0 065, 0 024, 7 493, 0 006 and 1 067 respectively. There was no difference of survival time between living liver transplantation and cadaver liver transplantation. The relative dangerous degree in cadaver liver transplantation was 0 340 as much as that in living liver transplantation. Conclusions Living liver transplantation shortens the waiting time of liver transplantation and alleviates patient′s suffering. It suits for children and adult and supports a selective liver transplantation.