摘要
目的探讨血总胆固醇(serum total cholesterol,TC)、血糖(serum glucose,Glu)及MELD(model for end-stage liver disease,MELD)评分单一及联合指标对乙型肝炎相关慢加急性肝衰竭近期预后(3个月)的评估价值。方法纳入104例乙型肝炎相关慢加急性肝衰竭患者临床资料,依患者近期(3个月)预后状况分为好转组和无效/恶化组,比较两组患者血总胆固醇、血糖以及MELD评分差异,采用ROC曲线分析各指标对患者预后预测的价值。结果入院时TC、Glu值,无效/恶化组均明显低于好转组;而MELD值明显高于好转组(P<0.05)。通过ROC曲线分析表明,单一指标中MELD评分对乙型肝炎相关慢加急性肝衰竭近期预后(3个月)的评估具有较好的价值,准确度、AUC、灵敏度与特异度分别为78.8%、0.788、0.822、0.739;联合指标(TC+Glu+MELD)对乙型肝炎相关慢加急性肝衰竭近期预后(3个月)的预测准确度最高,准确度、AUC、灵敏度与特异度分别为82.9%、0.829、0.822、0.848。结论入院时TC、Glu及MELD评分对乙型肝炎相关慢加急性肝衰竭短期预后具有预测价值,但TC+Glu+MELD对乙型肝炎相关慢加急性肝衰竭短期预后预测价值最高。
Objective To investigate serum total cholesterol(TC),serum glucose(Glu)and MELD(model for end-stage liver disease)score single and combined indicators for the evaluation of short-term prognosis(3 months)in hepatitis B-associated chronic acute liver failure.Methods The clinical data of 104 patients with hepatitis B related chronic plus acute liver failure were included.The patients were divided into improved group and invalid/deteriorated group according to their short-term prognosis(3 months).The differences of blood total cholesterol,blood glucose and MELD score between the two groups were compared,and the prognostic value of each index was analyzed by ROC curve.Results The TC and Glu values in the ineffective/deteriorated group were significantly lower than those in the improved group,MELD value was significantly higher than that of improvement group(P<0.05).ROC curve analysis showed that MELD score had a good value in the evaluation of short-term prognosis of hepatitis B associated chronic liver failure(3 months),the accuracy,AUC,sensitivity and specificity are 78.8%,0.788,0.822,0.739.The combined index(TC+Glu+MELD)has the highest accuracy in predicting the short-term prognosis(3 months)of hepatitis B-related chronic acute liver failure,with accuracy,AUC,sensitivity and specificity of 82.9%,0.829,0.822,and 0.848,respectively.Conclusion TC,Glu and MELD score on admission have predictive value for short-term prognosis of hepatitis B associated chronic plus acute liver failure,but the combined index(TC+Glu+MELD score)has highest accuracy for short-term prognosis of hepatitis B associated chronic plus acute liver failure.
作者
孔金峰
林太顺
陈丽芳
王少扬
KONG Jinfeng;LIN Taishun;CHEN Lifang;WANG Shaoyang(Department of Hepatology,Mengchao Hepatobiliary Hospital,Fujian Medical University,Fuzhou 350025,China;Infection department of the 900 Hospital of the joint logistics support force,Fuzhou 350025,China)
出处
《中国医药指南》
2021年第25期18-19,共2页
Guide of China Medicine