白蛋白-胆红素评分对乙肝肝硬化失代偿期患者短期预后的评估价值

Evaluation Value of Albumin-Bilirubin Score in Predicting the Short-Term Prognosis of Patients with Hepatitis B Virus Related Decompensated Cirrhosis

目的 探讨影响乙肝肝硬化失代偿期(HBV-DeCi)患者短期预后的危险因素,并评估白蛋白-胆红素(ALBI)评分的预测能力。方法 回顾性分析174例乙肝肝硬化失代偿期患者的临床资料,根据90 d临床转归分为生存组和病死组。运用多因素logistic回归分析影响患者预后的危险因素,通过受试者工作特征(ROC)曲线衡量ALBI评分、肝功能评分(Child-Pugh)及终末期肝病模型(MELD)对HBV-DeCi患者的预后判断能力。结果 ALBI评分、Child-Pugh评分、MELD评分、上消化道出血是HBV-DeCi患者死亡的独立危险因素(P<0.05)。ALBI预测死亡的ROC曲线下面积(AUC)为0.778(95%CI:0.708~0.837),与Child-Pugh[0.827(95%CI:0.762~0.880)]、MELD[0.848(95%CI:0.786~0.898)]的差异无统计学意义(P>0.05)。结论 除Child-Pugh评分和MELD评分外,ABLI可作为预测HBV-DeCi患者短期预后不良的有效工具,从而协助临床医生制定诊疗方案。

Objective To investigate the risk factors affecting the short-term prognosis of patients with hepatitis B virus related decompensated cirrhosis(HBV-DeCi),and elucidate the prognostic role of the albumin-bilirubin(ALBI) score.Methods Data of 174 patients who had been diagnosed with HBV-DeCi were retrospectively analyzed.According to their clinical outcomes in 90 days,they were divided into survival group and death group.Logistic regression was used to analyze the risk factors for mortality.The prognostic values of ALBI,Child-Pugh and mold for end-stage liver disease(MELD) were compared by receiver operating characteristic(ROC) curve.Results ALBI,Child-Pugh,MELD scores and upper gastrointestinal hemorrhage were independent risk factors for mortality in HBV-DeCi patients(P0.05).Conclusion In addition to Child-Pugh score and MELD score,ABLI is an effective tool to predict short-term mortality in patients with HBV-DeCi,and may assist physicians in determining treatment options.