血小板-白蛋白-胆红素评分与肝硬化患者肝功能Child-Turcotte-Pugh分级的相关性分析

Correlation Analysis of Platelet-Albumin-Bilirubin Scores and Child-Turcotte-Pugh Grade Liver Function in Patients with Cirrhosis

目的分析血小板-白蛋白-胆红素(PALBI)评分与肝硬化患者肝功能Child-Turcotte-Pugh(CTP)分级的相关性。方法选取237例肝硬化住院患者和同期89例健康体检者(对照组),根据CTP分级将肝硬化患者分为A、B、C级,根据PALBI评分水平将患者分为低PALBI评分组(118例)和高PALBI评分组(119例)。分析PALBI评分和其他评分体系与CTP评分的相关性,以及其他评分体系与PALBI评分的相关性。采用受试者工作特征(ROC)曲线检验各评分体系对肝硬化不同分级的诊断效能。结果肝硬化患者中CTP分级越高,PALBI评分越高(C级>B级>A级>对照组)。PALBI评分、天冬氨酸氨基转移酶和血小板比率指数(APRI)、肝纤维化4因子指数(FIB-4)、终末期肝病模型(MELD)评分与CTP分级呈正相关(r=0.766、0.423、0.552和0.538,P<0.001),PALBI评分与CTP评分的相关性优于APRI、FIB-4和MELD评分。PALBI评分预测肝硬化A、B、C级的ROC曲线下面积均高于APRI、FIB-4和MELD评分。结论PALBI评分与肝硬化CTP分级呈正相关,有助于评估患者肝硬化的严重程度。

Objective To analyze the correlation between platelet-albumin-bilirubin(PALBI)scores and Child-Turcotte-Pugh(CTP)grade of liver function in cirrhotic patients.Methods A total of 237 cirrhotic hospitalized patients and 89 healthy controls during the same period were enrolled.The cirrhotic patients were divided into grades A,B and C according to CTP grade.According to PALBI scores level,the patients were divided into low PALBI scores group(118 cases)and high PALBI scores group(119 cases).The correlation between PALBI scores,other scoring systems and CTP scores was analyzed,as well as the correlations between other scoring systems and PALBI scores.The diagnostic efficiency of each scoring system for different grades of cirrhosis was tested by receiver operating characteristic(ROC)curve.Results The higher the CTP grade,the higher the PALBI scores in cirrhotic patients(grade C>grade B>grade A>control).PALBI scores,aspartate aminotransferase to platelet ratio index(APRI),fibrosis 4 score(FIB-4)and model for end-stage liver disease(MELD)scores were positively correlated with CTP scores(r=0.766,0.423,0.552,0.538,P<0.001),and the correlation between PALBI scores and CTP scores was better than that between APRI,FIB-4 and MELD scores.The area under the ROC curve of PALBI scores predicting cirrhosis grades A,B and C were higher than APRI,FIB-4 and MELD scores.Conclusions The PALBI scores was significantly and positively correlated with the CTP grade of cirrhosis,which helped to assess the severity of cirrhosis in patients.