肝衰竭预后模型研究新进展

doi:10.3969/j.issn.1672-5069.2016.04.034

摘要/Abstract

摘要： 肝衰竭患者并发症多,病死率高,及时准确评估肝衰竭患者预后,对于治疗方案的选择和治疗过程的把握十分重要,并最终改善肝衰竭患者的预后。本文对近几年出现的新的肝衰竭预后模型进行了综述,包括MELD评分、SOFA评分、改良的SOFA评分、ALFED模型,并提出了一个新的急性肝衰竭预后评分模型的优缺点和运用条件。另外,对新出现的肝衰竭生物标志物进行了归纳和总结。

关键词: 肝衰竭, 预后, 模型, 生物标志物

Abstract: There are many complications in patients with liver failure,which might lead to high mortality. Assessing the prognosis of patients with liver failure in time and accurately is very important for this kind of patients. Here we reviewed the new models in recent years,including the advantages,disadvantages and the use of conditions of MELD score, SOFA score, improved SOFA score,and ALFED model. We also discussed some new biological markers of liver failure.

Key words: Liver failure, Prognosis, Model, Biological markers

倪清涛综述, 杨永峰审校. 肝衰竭预后模型研究新进展[J]. 实用肝脏病杂志, 2016, 19(4): 500-504.

Ni Qingtao, Yang Yongfeng. Insight into the study of prognosis model for patients with liver failure[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(4): 500-504.

参考文献

[1] 中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南.实用肝脏病杂志,2013,16（3）:210-216.
[2] Shakil A,Kramer D,Mazariegos G,et al.Acute liver failure: clinical features,outcome analysis,and applicability of prognostic criteria. Liver Transplant,2000,6（2）:163-169.
[3] Malinchoc M,Kamath PS,Gordon FD,et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts.Hepatology,2000,31（4）:864- 871.
[4] Kamath PS,Wiesner RH,Mallnchoc M,et al. A model to predict survival in patients with end-stage liver disease. Hepatology,2001,33（2）:464-470.
[5] Boone MD,Celi LA,Ho BG,et al. Model for end-stage liver disease score predicts mortality in critically ill cirrhotic patients. J Crit Care,2014,29（5）:881.e7-e13.
[6] Hye SS,Sae PK,Sang HH,et al. Prognostic indicators for acute liver failure development and mortality in patients with hepatitis A:Consecutive case analysis. Yonsei Med J,2014,55（4）:953-959.
[7] Wang X,Wang BM,Li B,et al. A clinical prediction model and its application for bleeding in chronic liver failure patients with esophageal varices. Eur Rev Med Pharmacol Sci,2013,17（22）:3046-3055.
[8] Lee HS,Choi GH,Joo DJ,et al. Prognostic value of model for end-stage liver disease scores in patients with fulminant hepatic failure. Transplant Proc,2013,45（8）:2992-2994.
[9] Ha JM,Sohn W,Cho JY,et al. Static and dynamic prognostic factors for hepatitis-B-related acute-on-chronic liver failure. Clin Mol Hepatol,2015,21（3）:232-241.
[10] McPhail MJ, Farne H,Senvar N,et al. Ability of King's college criteria and model for end-stage liver disease scores to predict mortality of patients with acute liver failure:A Meta-analysis. Clin Gastroenterol Hepatol,2015,20.pii:S1542-3565（15）01403-2.doi:10.1016.
[11] Murugesh M,Niraj RS,Madhu S,et al. Retrospective and prospective validation of model for end-stage liver disease （MELD） score in predicting mortality in patients of alcoholic liver disease. Trop Gastroenterol,2013,34（4）:252-258.
[12] Selcuk H,Uruc I,Temel MA,et al. Factors prognostic of survival in patients awaiting liver transplantation for end-stage liver disease. Dig Dis Sci,2007,52（11）:3217-3223.
[13] Huadong Y,Wu W,Yang Y,et al. A novel integrated Model for end-stage liver disease model predicts short-term prognosis of hepatitis B virus-related acute-on-chronic liver failure patients. Hepatol Res,2015,45（4）:405-414.
[14] Vincent JL,Moreno R,Takala J,et al. The SOFA（Sepsis- related organ failure assessment） score to describe organ dysfunction/failure. Working Group on“sepsisrelated problems”of the European Society of Intensive Care Medicine. Int Care Med,1996,22（7）:707-710.
[15] Cholongitas EB,Betrossian A,Leandro G,et al. King’s criteria, APACHE II,and SOFA scores in acute liver failure. Hepatology,2006,43（4）:881-882.
[16] Vincent JL,de Mendonca A,Cantraine F,et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units:results of a multicenter,prospective study. Working group on“sepsis- related problems”of the European Society of Intensive Care Medicine. Crit Care Med,1998,26（11）:1793-1800.
[17] Frhlich S,Murphy N,Kong T,et al. Alcoholic liver disease in the intensive care unit：outcomes and predictors of prognosis. J Crit Care,2014,29（6）:1131.e7-e13.
[18] Moreau R,Jalan R,Gines P,et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology,2013,144:1426-37 1437.e1-9.
[19] Pan HC,Jenq CC,Tsai MH,et al. Scoring systems for 6-month mortality in critically ill cirrhotic patients:a prospective analysis of chronic liver failure sequential organ failure assessment score （CLIF-SOFA）. Aliment Pharmacol Therapeut,2014,40（9）:1056-1065.
[20] McPhail MJ,Shawcross DL,Abeles RD,et al. Increased survival for patients with cirrhosis and organ failure in liver intensive care and validation of the chronic liver failure-sequential organ failure scoring system. Clin Gastroenterol Hepatol,2015,13（7）:1353-1360.
[21] Kumar R,Shalimar H,Sharma H,et al. Prospective derivation and validation of early dynamic model for predicting outcome in patients with acute liver failure. Gut,2012,61（7）:1068-1075.
[22] Naiki T,Nakayama N,Mochida S,et al. Novel scoring system as a useful model to predict the outcome of patients with acute liver failure:Application to indication criteria for liver transplantation.Hepatol Res,2012,42（1）:68-75.
[23] 段钟平,郑素军,陈鹏,等. 肝衰竭预后评价新标志物研究进展.传染病信息,2009,22（5）:265-268.
[24] Schidt FV,Ostapowicz G,Murray N,et al. Alpha-fetoproteinand prognosis in acute liver failure. Liver Transplant,2006,12（12）:1776-1781.
[25] Jorge LV,Norberto CT,Guadalupe PR,et al. Bilirubin alone as a biomarker for short-term mortality in acute-on-chronic liver failure:an important prognostic indicator. Ann Hepatol,2014,13（1）: 98-104.
[26] Macquillan GC,Seyam MS,Nightingale P,et al. Blood lactate but not serum phosphate levels can predict patient outcome in fulminant hepatic failure.Liver Transplant,2005,11（9）:1073-1079.
[27] Li YL,Chang CJ,Cheng SL,et al. Proteinuria can predict short-term prognosis in critically ill cirrhotic patients. Clin Gastroenterol,2014,48（4）:377-382.
[28] Bernal W,Hall C,Karvellas CJ,et al. Arterial ammonia and clinical risk factors for encephalopathy and intracranial hypertension in acute liver failure.Hepatology,2007,46（6）:1844-1852.
[29] Liu H,Zhang H,Wan G,et al. Neutrophil-lymphocyte ratio: a novel predictor for short-term prognosis in acute-on-chronic hepatitis B liver failure. J Viral Hepat,2013,21（7）:499-507.
[30] Wang K,Wu ZB,Ye YN,et al. Plasma interleukin-10:A likely predictive marker for hepatitis B virus-related acute-on-chronic liver failure. Hepat Month,2014,14（7）:e19370.
[31] Feng HL,Li Q,Wang L,et al. Indocyanine green clearance test combined with MELD score in predicting the short-term prognosis of patients with acute liver failure. Hepatobiliary Pancreat Dis Int,2014,13（3）:271-275.
[32] Nakamura M. Clinical significance of autoantibodies in primary biliary cirrhosis. Sem Liver Dis,2014,34（3）:334-340.
[33] Gao S,Ji X,Ji F,et al. Aberrant DNA methylation of G-protein-coupled bile acid receptor Gpbar1 predicts prognosis of acute-on-chronic hepatitis B liver failure.J Viral Hepat,2015,22（2）:112-119.
[34] Stauber RE,Walter S,Josef H,et al. Human nonmercaptalbumin-2:A novel prognostic marker in chronic liver failure. Therapeut Apher Dial,2014,18（1）:74-78.
[35] 郑以山,吴宗盛,杨永峰,等. 血浆半乳糖凝集素-3水平对慢加亚急性肝衰竭预后的判断作用.中华肝脏病杂志,2014,22（4）:295-298.