MELD评分联合Th1/Th2细胞因子在预测乙型肝炎肝衰竭短期预后中的价值

Research of MELD score combined with Th1/Th2 cytokines in predicting short-term prognosis of liver failure caused by hepatitis B

目的:评价MELD评分联合Th1/Th2细胞因子对乙型肝炎肝衰竭短期预后的预测价值。方法:以58例乙肝肝衰竭患者作为研究对象,对不同疾病分期的患者进行MELD评分、检测患者外周血Th1/Th2细胞因子水平,评估患者短期死亡风险。结果:肝衰竭早期(19例)、中期(22例)以及晚期(17例)患者的MELD评分分别为(16.27±3.38)分、(22.15±3.41)分以及(27.30±3.52)分,3个组间比较,差异有统计学意义(F=4.962,P=0.000);各期患者Th2细胞因子IL-4、IL-6及IL-10的表达水平比较,差异均有统计学意义(F_(IL-4)=3.912,P_(IL-4)=0.009;F_(IL-6)=6.744,P _(IL-6)=0.000;F_(IL-10)=10.308,P_(IL-10)=0.000);肝衰竭早期、中期、晚期患者的高死亡风险率分别为15.79%(3/19)、31.82%(7/22)及76.47%(13/17),各组间比较,早期肝衰竭患者低于中期患者(χ~2=3.892,P=0.039),也低于晚期患者(χ~2=13.380,P=0.000),中期肝衰竭患者低于晚期患者(χ~2=7.653,P=0.000)。结论:MELD评分联合血清Th1/Th2细胞因子检测能较好地预测乙肝肝衰竭患者的短期预后,具有推广应用价值。

Objective:To evaluate the function of MELD score combined with Th1/Th2 cytokines in predicting short-term prognosis of liver failure caused by hepatitis B.Methods:MELD scores of 58 cases of patients with liver failure caused by hepatitis B at different stages were calculated and the levels of Th1/Th2 cytokines were tested.Then the mortality risk in a short term was evaluated.Results:MELD score of patients at early stage(19 cases)was(16.27±3.38),which was lower than(22.15±3.41)of the patients at medium stage(22 cases)and(27.30±3.52)of the patients at late stage(17 cases)(F=4.962,P=0.000).There were differences in expression levels of IL-4、IL-6 and IL-10 of Th2 cytokine of patients at different stages(FIL-4=3.912,PIL-4=0.009;FIL-6=6.744,PIL-6=0.000;FIL-10=10.308,PIL-10=0.000).The mortality rates were 15.79%(3/19),31.82%(7/22)and 76.47%(13/17)respectively at early stage,medium stage and late stage.The mortality rate at early stage was lower than that at medium stage(χ2=3.892,P=0.039),and lower than that at late stage(χ2=13.380,P=0.000),and the mortality rate at medium stage was lower than that at late stage(χ2=7.653,P=0.000).Conclusions:MELD score combined with Th1/Th2 cytokines can well predict the short-term prognosis of liver failure caused by hepatitis B,which can be widely popularized and applied.