肝衰竭预后评估模型及其在妊娠期肝衰竭中的应用

韩璞青; 孙嫣

doi:10.3969/j.issn.1001-5256.2018.03.044

肝衰竭预后评估模型及其在妊娠期肝衰竭中的应用

DOI: 10.3969/j.issn.1001-5256.2018.03.044

韩璞青,
孙嫣

广州医科大学附属第三医院消化内科

详细信息

中图分类号: R714.255
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出版历程
- 收稿日期: 2017-08-28
- 出版日期: 2018-03-20

Prognostic models for liver failure and their role in pregnant women with liver failure

Han PuQing,
Sun Yan

Department of Gastroenterology, The Third Affiliated Hospital of Guangzhou Medical University

摘要

摘要: 妊娠期肝衰竭发病率相对升高,是孕产妇死亡主要病因之一。妊娠期肝衰竭症状复杂、并发症多,严重威胁母婴安全。真实客观地判断肝衰竭患者预后是指导临床工作的重点内容。介绍了影响肝衰竭患者预后的单因素指标及各种多因素模型,以及常用模型在妊娠期患者中的应用,以期为临床工作提供参考。
- 肝功能衰竭 /
- 妊娠并发症 /
- 预后 /
- 综述
Abstract: Pregnant women have a higher incidence rate of liver failure than women who are not pregnant, and liver failure is one of the major causes of death in pregnant women and parturients. Liver failure in pregnancy has complex symptoms and various complications and greatly threatens the safety of mothers and infants. Accurate judgment of the prognosis of patients with liver failure plays an important role in guiding clinical work. This article introduces the influencing factors for the prognosis of patients with liver failure and the application of various models in pregnant women, in order to provide a reference for clinical work.
- liver failure /
- pregnancy complications /
- prognosis /
- review

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参考文献(45)

[1]Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association;Severe Liver Diseases and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association.Guidelines for diagnosis and treatment liver failure[J/CD].Chin J Transplant:Electronic Edition, 2013, 7 (1) :48-56. (in Chinese) 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 (2012年版) [J/CD].中华移植杂志:电子版, 2013, 7 (1) :48-56.

[2]CHENG JX, SUN LH, ZHANG YX.Research progress on prognosis evaluation of liver failure[J].Chin J Clin Infect Dis, 2014, 7 (2) :188-192. (in Chinese) 程家喜, 孙丽华, 张跃新.肝衰竭预后评估的研究进展[J].中华临床感染病杂志, 2014, 7 (2) :188-192.

[3]MIYAKE Y, IWASAKI Y, MAKINO Y, et al.Prognostic factors for fatal outcomes prior to receiving liver transplantation in patients with non-acetaminophen-related fulminant hepatic failure[J].J Gastroenterol Hepatol, 2007, 22 (6) :855-861.

[4]MA CH, CHEN Y, CHEN CW, et al.Prognostic value of indocyanine green and liver reserve function in acute and acute-on-chronic liver failure patients[J].J Clin Hepatol, 2012, 28 (5) :372-374. (in Chinese) 马春华, 陈煜, 陈成伟, 等.吲哚菁绿清除试验对急性/慢加急性肝衰竭患者预后的评价[J].临床肝胆病杂志, 2012, 28 (5) :372-374.

[5]LI YB, ZHANG J, CHEN J, et al.Clinical significance of serum phosphorus andα-fetoprotein in patients with liver failure[J].Chin J Infect Dis, 2014, 32 (8) :470-473. (in Chinese) 李友炳, 张军, 陈靖, 等.肝功能衰竭患者血清磷和甲胎蛋白检测的临床意义[J].中华传染病杂志, 2014, 32 (8) :470-473.

[6]CHEN W, GAO GS, DONG FB, et al.Short-term prognosis of acute-on-chronic liver failure evaluated by serum procalcitonin level, Child-Turcotte-Pugh score and model for end-stage liver disease score[J].Chin J Clin Infect Dis, 2014, 7 (5) :464-467. (in Chinese) 陈巍, 高国生, 董飞波, 等.血清降钙素原、Child-TurcottePugh评分和终末期肝病模型评分对慢加急性肝衰竭患者短期预后的评价[J].中华临床感染病杂志, 2014, 7 (5) :464-467.

[7]ZHENG YB, HUANG ZL, WU ZB, et al.Dynamic changes of clinical features that predict the prognosis of acute-on-chronic hepatitis B liver failure:a retrospective cohort study[J].Int J Med Sci, 2013, 10 (12) :1658-1664.

[8]BUTTERWORTH RF.Pathogenesis of hepatic encephalopathy and brain edema in acute liver failure[J].J Clin Exp Hepatol, 2015, 5 (Suppl 1) :s96-s103.

[9]FICHET J, MERCIER E, GENEE O, et al.Prognosis and 1-year mortality of intensive care unit patients with severe hepatic encephalopathy[J].J Crit Care, 2009, 24 (3) :364-370.

[10]PAN C, XU LJ, ZHOU R, et al.Multivariate analysis of hepatic encephalopathy occurrence in patients with liver failure[J].Chin J Hepatol, 2012, 20 (6) :434-437. (in Chinese) 潘晨, 许利军, 周锐, 等.乙型肝炎肝衰竭患者发生肝性脑病的多因素分析[J].中华肝脏病杂志, 2012, 20 (6) :434-437.

[11]PUGH RN, MURRAY-LYON IM, DAWSON JL, et al.Transection of the oesophagus for bleeding oesophageal varices[J].Br J Surg, 1973, 60 (8) :646-649.

[12]DUSEJA A, CHOUDHARY NS, GUPTA S, et al.APACHE II score is superior to SOFA, CTP and MELD in predicting the short-term mortality in patients with acute-on-chronic liver failure (ACLF) [J].J Dig Dis, 2013, 14 (9) :484-490.

[13]GARG H, KUMAR A, GARG V, et al.Clinical profile and predictors of mortality in patients of acute-on-chronic liver failure[J].Dig Liver Dis, 2012, 44 (2) :166-171.

[14]KIM HJ, LEE HW.Important predictor of mortality in patients with end-stage liver disease[J].Clin Mol Hepatol, 2013, 19 (2) :105-115.

[15]CHAWLA YK, KASHINATH RC, DUSEJA A, et al.Predicting mortality across a broad spectrum of liver disease-an assessment of model for end-stage liver disease (MELD) , Child-TurcottePugh (CTP) , and Creatinine-Modified CTP Scores[J].J Clin Exp Hepatol, 2011, 1 (3) :161-168.

[16]MALINCHOC M, KAMATH PS, GORDON FD, et al.A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts[J].Hepatology, 2000, 31 (4) :864-871.

[17]KAMATH PS, WIESNER RH, MALINCHOC M, et al.A model to predict survival in patients with end-stage liver disease[J].Hepatology, 2001, 33 (2) :464-470.

[18]SHI XY, ZHANG YQ, ZHU P, et al.Prognostic risk factors in patients with hepatitis B virus-related acute-on-chronic liver failure[J].J Clin Hepatol, 2016, 32 (4) :700-705. (in Chinese) 石新星, 张艳琼, 朱鹏, 等.乙型肝炎相关慢加急性肝衰竭患者预后的危险因素分析[J].临床肝胆病杂志, 2016, 32 (4) :700-705.

[19]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[J].Clin Gastroenterol Hepatol, 2016, 14 (4) :516-525.

[20]MATHUR S, GANE EJ, MCCALL JL, et al.Serum sodium and hydration status predict transplant-free survival independent of MELD score in patients with cirrhosis[J].J Gastroenterol Hepatol, 2008, 23 (2) :239-243.

[21]YOUNG AL, RAJAGENASHAN R, ASTHANA S, et al.The value of MELD and sodium in assessing potential liver transplant recipients in the United Kingdom[J].Transpl Int, 2007, 20 (4) :331-337.

[22]BIGGINS SW, KIM WR, TERRAULT NA, et al.Evidence-based incorporation of serum sodium concentration into MELD[J].Gastroenterology, 2006, 130 (6) :1652-1660.

[23]HSU CY, LIN HC, HUANG YH, et al.Comparison of the model for end-stage liver disease (MELD) , MELD-Na and MELDNa for outcome prediction in patients with acute decompensated hepatitis[J].Dig Liver Dis, 2010, 42 (2) :137-142.

[24]KIM JM, KWON CH, JOH JW, et al.Can the model for endstage liver disease score replace the indocyanine green clearance test in the selection of right hemihepatectomy in Child-Pugh class A[J].Ann Surg Treat Res, 2014, 86 (3) :122-129.

[25]O'GRADY JG, ALEXANDER GJ, HAYLLAR KM, et al.Early indicators of prognosis in fulminant hepatic failure[J].Gastroenterology, 1989, 97 (2) :439-445.

[26]CHOLONGITAS E, THEOCHARIDOU E, VASIANOPOULOU P, et al.Comparison of the sequential organ failure assessment score with the King's College Hospital criteria and the model for endstage liver disease score for the prognosis of acetaminophen-induced acute liver failure[J].Liver Transpl, 2012, 18 (4) :405-412.

[27]FIKATAS P, LEE JE, SAUER IM, et al.APACHE III score is superior to King’s College Hospital criteria, MELD score and APACHE II score to predict outcomes after liver transplantation for acute liver failure[J].Transplant Proc, 2013, 45 (6) :2295-2301.

[28]VINCENT JL, MORENO R, TAKALA J, et al.The SOFA (Sepsisrelated Organ Failure Assessment) score to describe organ dysfunction/failure.On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine[J].Intensive Care Med, 1996, 22 (7) :707-710.

[29]CHOLONGITAS EB, BETROSSIAN A, LEANDRO G, et al.King's criteria, APACHE II, and SOFA scores in acute liver failure[J].Hepatology, 2006, 43 (4) :881-882.

[30]LI XS, LYU HM, LI FH, et al.Values of MELD, MELD-Na and SOFA scores for prediction of liver failure[J].Tianjin Med J, 2012, 40 (9) :902-904. (in Chinese) 李晓爽, 吕洪敏, 李凤惠, 等.MELD、MELD-Na、SOFA评分系统对肝衰竭短期预后的价值[J].天津医药, 2012, 40 (9) :902-904.

[31]YAMAGISHI Y, SAITO H, EBINUMA H, et al.A new prognostic formula for adult acute liver failure using computer tomography-derived hepatic volumetric analysis[J].J Gastroenterol, 2009, 44 (6) :615-623.

[32]KUMAR R, SHALIMAR, SHARMA H, et al.Prospective derivation and validation of early dynamic model for predicting outcome in patients with acute liver failure[J].Gut, 2012, 61 (7) :1068-1075.

[33]RUTHERFORD A, KING LY, HYNAN LS, et al.Development of an accurate index for predicting outcomes of patients with acute liver failure[J].Gastroenterology, 2012, 143 (5) :1237-1243.

[34]BECHMANN LP, JOCHUM C, KOCABAYOGLU P, et al.Cytokeratin 18-based modification of the MELD score improves prediction of spontaneous survival after acute liver injury[J].J Hepatol, 2010, 53 (4) :639-647.

[35]XIONG HF, LIU JY, GUO LM, et al.Acute fatty liver of pregnancy:over six months follow-up study of twenty-five patients[J].World J Gastroenterol, 2015, 21 (6) :1927-1931.

[36]YU Y, ZHENG HL, MA F, et al.A clinical study of plasma exchange combined with continuous veno-venous hemodiafiltration in acute fatty liver of pregnant with acute liver and renal failure[J].Chin J Med Offic, 2016, 4 (7) :670-673. (in Chinese) 于艳, 郑昊林, 马峰, 等.血浆置换联合连续性静脉-静脉血液透析滤过治疗妊娠期急性脂肪肝伴急性肝肾功能衰竭[J].临床军医杂志, 2016, 4 (7) :670-673.

[37]FENG Y.Clinical analysis of 42 cases of pregnancy complicated with severe hepatitis[J].Clin J Chin, 2014, 30 (9) :961-963. (in Chinese) 冯颖.妊娠合并重症肝炎42例临床分析[J].中国综合临床, 2014, 30 (9) :961-963.

[38]LI XM, DENG LZ, YANG YB, et al.Clinical significance of serum cholesterol in predicting the prognosis of pregnancy complicating hepatitis gravis[J].J Sun Yat-Sen Univ:Medical Sciences, 2008, 29 (5) :595-597. (in Chinese) 李小毛, 邓柳枝, 杨越波, 等.血清胆固醇水平在妊娠合并重型肝炎预后判断中的临床意义[J].中山大学学报:医学科学版, 2008, 29 (5) :595-597.

[39]FANG L, WU L, ZHAGN Y, et al.Multivariate analysis of prognostic factors for fulminant hepatitis in pregnancy[J].Chin J Clinicians, 2009, 3 (4) :568-573. (in Chinese) 方莉, 伍玲, 张宇, 等.影响妊娠合并重型肝炎预后的临床多因素分析[J].中华临床医师杂志, 2009, 3 (4) :568-573.

[40]SOLANKE D, RATHI C, PANDEY V, et al.Etiology, clinical profile, and outcome of liver disease in pregnancy with predictors of maternal mortality:a prospective study from Western India[J].Indian J Gastroenterol, 2016, 35 (6) :450-458.

[41]YANG Y, DENG L, LI X, et al.Evaluation of the prognosis of fulminant viral hepatitis in late pregnancy by the MELD scoring system[J].Eur J Clin Microbiol Infect Dis, 2012, 31 (10) :2673-2678.

[42]MURALI AR, DEVARBHAVI H, VENKATACHALA PR, et al.Factors that predict 1-month mortality in patients with pregnancy-specific liver disease[J].Clin Gastroenterol Hepatol, 2014, 12 (1) :109-113.

[43]WESTBROOK RH, YEOMAN AD, O'GRADY JG, et al.Model for end-stage liver disease score predicts outcome in cirrhotic patients during pregnancy[J].Clin Gastroenterol Hepatol, 2011, 9 (8) :694-649.

[44]DENG LZ, LI XM, CHEN DJ, et al.Then effect of MELD scoring system for predicting the short term prognosis of pregnancy complicating fulminant hepatitis[J].Chin J Prac Gynecol Obstetr, 2010, 26 (3) :209-212. (in Chinese) 邓柳枝, 李小毛, 陈敦金, 等.终末期肝病模型评分对妊娠合并重型肝炎短期预后的评价作用[J].中国实用妇科与产科杂志, 2010, 26 (3) :209-212.

[45]YU L, ZENG LP.Analysis of MELD score and termination of pregnancy for pregnancy combined with serious hepatitis[J].Mod J Inte Tradit Chin West Med, 2010, 19 (5) :524-528. (in Chinese) 于琳, 曾荔苹.妊娠合并重型肝炎患者MELD评分分析与终止妊娠时机[J].现代中西医结合杂志, 2010, 19 (5) :524-528.

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