终末期肝病模型和Child-Pugh分级对失代偿期肝硬化患者的预后分析.docVIP

终末期肝病模型及Child-Pugh分级对失代偿期肝硬化患者的预后分析 作者：占国清，郑三菊，朱琳，王崇慧，李金科，张薇薇 作者单位：湖北十堰 郧阳医学院附属人民医院肝病研究所，442000 【摘要】目的 探讨终末期肝病模型(MELD)及Child-Pugh评分对失代偿期肝硬化预后评估的应用价值。方法 应用MELD评分公式及Child-Pugh分级对136例失代偿期肝硬化患者进行评分及分级，比较两种系统对肝硬化预后的评估。结果 分别有19.85%和33.82%患者3个月和6个月内死亡，死亡组MELD和Child-Pugh评分均高于生存组(P0.001);MELD评分在3个月预后评估的ROC曲线AUC高于Child-Pugh评分(P0.05);生存分析表明MELD与Child-Pugh评分均可有效地分辨6个月内可能生存及死亡的患者(P0.005);MELD评分与Child评分显著相关(r=0.67，P0.001)。结论 MELD评分及Child-Pugh评分均可预测失代偿期肝硬化患者短期预后，MELD评分短期评估优于Child-Pugh分级。 【关键词】 失代偿期肝硬化 MELD评分 Child-Pugh分级 预后 The analysis of prognosis of patients with decompensated liver cirrhosis using the criterion of the model for end-stage liver disease and Child-Pugh gradingZHANG Guo-qing, ZHENG San-ju, ZHU Lin, et al. Department of Hepatology, People Hospitol, Yunyang Medical College, Shiyan 442000, China Abstract:Objective To investigate the prognosis value of the Model for End-stage Liver Disease(MELD) and Child-Pugh grading in patients with decompensated liver cirrhosis.Methods 136 patients with decompensated liver cirrhosis were graded with MELD formula and with Child-Pugh, and the prognosis value were compared.Results 19.85% and 33.82% of the died within three and six month term respectively, MELD and Child-Pugh score for deaths were higher than those for survivors significantly (P0.001). Area under the ROC of MELD was higher than that of Child-Pugh for three month term (P0.05). Survival analysis showed MELD and Child-Pugh grading could clearly discriminate between patients who survived or died in six month term(P0.005).MELD values had significant correlation with Child-Pugh scores (r=0.67,P0.001).Conclusion Both MELD and Child-Pugh scores can accurately predict the short-term prognosis of patients with decompensated liver cirrhosis, MELD grading is more efficient than Child-Pugh score for short-term prognosis. Keywords:Decompensated liver cirrhosis; Model for End-stage Liver Disease scoring; Child-Pugh grading;