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The analysis of the short-term prognostic of cirrhotic patients using the criterion of model for end-stage liver disease and Child-Pugh grading
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摘要: 评价终末期肝病模型（MELD）评分、Child-Pugh（CTP）及包含血肌酐值的CTP（CrCTP）分级对肝硬化患者的短期预后的意义。分别计算104例肝硬化患者的MELD、CTP及CrCTP分值,运用ROC曲线及曲线下面积（AUC）比较MELD评分、CTP及CrCTP分级判断肝硬化患者3个月生存率的准确性。在判断患者3个月生存率的ROC曲线AUC比较中,MELD评分>CrCTP分级>CTP分级（P<0.05）。提示在CTP中引入血肌酐值可以提高CTP分级对肝硬化患者短期预后的判断准确性;MELD评分在判断肝硬化患者的短期预后方面优于CTP及CrCTP。
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关键词:
- 肝硬化 /
- MELD评分 /
- Child-Pugh分级 /
- 血清肌酐
Abstract: To evaluate the short-term prognostic meaning of the model for end-stage liver disease (MELD) score, Child-Pugh (CTP) and the creatinine-modified CTP (CraCTP) grading.104 patients with liver cirrhosis were studied and followed up for 3 months.The MELD, CTP and CrCTP scores were calculated for all the 104 patients.The accuracy of the three parameters on predicting 3-month survival were analyzed and compared with each other using the area under the receiver operating characteristic (ROC) curve (AUC) .The AUC values generated by the ROC curves for the MELD were 0.96, higher than the CTP and the CrCTP (P<0.05) .It suggested that the involvement of serum creatinine might improve the values of Child-TurcottePugh score, and the MELD score migh outstrip the CTP and CrCTP in the short-term prognostic assessment of cirrhotic patients.-
Key words:
- liver cirrhosis /
- MELD score /
- Child-Pugh grading /
- serum creatinine
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[1]Kamath PS, Wiesner RH, Malinchoc M, et al.Amodel to predictsurvival in patients with end-stage liver disease[J].Hepatology, 2001, 33 (2) ∶464-470. [2]Giannini E, Botta F, Fumagalli A, et al.Can inclusion of serumcreatinine values improve the Child-Turcotte-Pugh score and chal-lenge the prognostic yield of the model for end-stage liver diseasescore in the short-term prognostic assessment of cirrhotic patients[J].Liver Int, 2004, 24 (5) ∶465-70. [3]Garcia-Tsao G, Elferink RO.MELD:the End of Child-PughClassification[J].J Hepatology, 2002, 36∶141-145. [4]周友发, 黄敏, 邓国孙.乙肝肝硬化预后因素分析[J].宁夏医学杂志, 2000, 22 (8) ∶453-454. [5]Hanley JA, McNeil BJ.The meaning and use of the area under a re-ceiver operating characteristic (ROC) curve[J].Radiology, 1982, 143∶29236. -
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