肝损伤指数判断慢性肝炎转归的临床意义

Liver damage score for evaluation of the severity and prognosis of chronic liver diseases

目的 :建立一种生物数学指数判断肝损伤程度 ,评价慢性肝病患者预后 ,判定不同治疗方案的疗效。方法 :由肝脏蛋白合成能力、抗体产生水平、细胞裂解程度、胆汁郁积和肾功能损害等构成以生物数学和病理生理学为基础的肝损伤指数 (liverdamagescore ,LDS) ,对 4 86例慢性肝病患者的肝损伤程度、预后及疗效进行临床分析。结果 :LDS为 1.5～ 3U时 ,肝损伤为轻度 ;LDS为 3.7～ 5 .7U时 ,肝损伤为中等 ;LDS为 6～ 8U时 ,肝损伤较重 ;LDS >8U时 ,肝损伤最重 ,预后差 ;LDS能够反映疾病进展的过程和疗效。结论 :LDS是一种新的、简单而易操作的生物数学指数 ,能定量反映肝损伤程度和慢性肝病的发展过程 ,对指导临床治疗和判定预后具有重要意义。

Objective:To develop a biomathematical index for the estimation of the severity of liver damage, and to evaluate its capability for predicting prognosis of patients with chronic liver disease, for the estimation of the efficacy of different therapeutic regimens.Methods:Variables for reduced protein synthesis, increased production of antibodies, cytolysis, cholestasis, functional renal failure were combined into liver damage score (LDS) according to the results of cluster analysis. The evaluation of the liver injury and prognosis were analyzed in 486 patients with different liver diseases.Results:There were four groups of liver diseases: mild with LDS of 1.5-3?U, moderate with LDS of 3.7-5.7?U, severe with LDS of 6-8?U, the most severe with LDS >8?U. Values above 6 carried bad prognoisis. The LDS truthfully reflected the evolution of liver diseases over time and the efficacy of therapy.Conclusion:The LDS is a new, simple, low_cost, biomathematical and pathophysiological index for all patients with liver diseases. It allows a quantitative expression of the severity,the improvement or deterioration of the disease efficacy.