多种肝功能评分系统预测血浆置换治疗肝衰竭患者预后的价值探讨

doi:10.3969/j.issn.1672-5069.2014.06.025

摘要/Abstract

摘要： 目的探讨终末期肝病模型（MELD）和MELD-Na评分系统及Child-Pugh分级系统对血浆置换治疗的肝衰竭患者预后的价值。方法回顾性分析我院2005年1月至2012年9月收治的238例乙型肝炎肝衰竭患者的临床资料,应用MELD、MELD-Na和Child-Pugh评分系统判断患者在观察3个月期内的预后情况。结果在3个月的观察期内,本组患者生存145例,死亡93例（39.1%）;生存患者入院时凝血酶原时间、INR、血清总胆红素、血清钠和肌酐水平分别为（19.6±3.7）秒、（1.6±2.2）、（199.8±50.6） μmol/L、（137.6±7.7） mmol/L和（127.3±10.8） μmol/L,与死亡患者比[分别为（25.3±5.8）秒、（2.3±1.5）、（332.7±120.9） μmol/L、（127.0±14.6） mmol/L和（210.7±75.3） μmol/L],均有显著性统计学差异（P<0.01）;生存患者MELD、MELD-Na和Child-Pugh计分分别为（19.3±6.9）、（21.1±4.6）和（11.4±2.3）,均显著低于死亡患者[分别为（29.2±13.4）、（32.4±5.7）和（15.2±6.7）,P<0.05];MELD-Na和MELD评分系统在预测肝衰竭近期病死率方面优于Child-Pugh分级计分。结论MELD、MELD-Na评分系统和Child-Pugh分级系统对于肝衰竭患者的病情判断均有较好的价值,但MELD和MELD-Na评分系统对肝衰竭预后判断的价值更高。

关键词: 肝衰竭, 终末期肝病模型, Child-Pugh分级, 血浆置换, 预后

Key words: Hepatic failure, Model for end-stage liver disease, Child-Pugh score, Plasma exchange

曹力, 徐海峰. 多种肝功能评分系统预测血浆置换治疗肝衰竭患者预后的价值探讨[J]. 实用肝脏病杂志, 2014, 17(6): 652-655.

Cao Li, Xu Haifeng. Model for end-stage liver disease and Child-Pugh score in short-term prediction of patients with liver failure receiving plasma exchange[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(6): 652-655.

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