中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

HBV相关慢加急性肝衰竭短期预后模型的建立及评价

王嘉鑫 程娜 向天新 李淑悦 肖金平 邬小萍

引用本文:
Citation:

HBV相关慢加急性肝衰竭短期预后模型的建立及评价

DOI: 10.3969/j.issn.1001-5256.2019.06.023
基金项目: 

江西省重点研发计划项目(20181BBG78009); 

详细信息
  • 中图分类号: R575.3;R512.62

Establishment and evaluation of short-term prognostic model for hepatitis B virus-related acute-on-chronic liver failure

Research funding: 

 

  • 摘要:

    目的建立一个新型的HBV相关慢加急性肝衰竭(HBV-ACLF)短期预后预测模型:MACLF,并评价MACLF评分对HBV-ACLF患者短期预后的预测价值。方法采用回顾性队列研究分析2015年1月-2018年11月南昌大学第一附属医院收治的270例HBV-ACLF患者的临床资料,根据3个月的病情随访情况分为生存组(n=153)和死亡组(n=117),对影响HBV-ACLF患者短期预后的相关因素进行分析。计数资料2组间比较采用卡方检验,计量资料2组间比较分别采用Mann-Whitney U检验,采用二元logistic回归分析进行多因素分析,多因素分析有意义的指标再次进行二元logistic回归分析并建立模型。绘制受试者工作特征曲线(ROC曲线)评价MACLF评分对HBV-ACLF患者短期预后的预测价值。结果单因素分析结果显示:游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)、国际标准化比值(INR)、中性粒细胞/淋巴细胞比值(NLR)、PLT、ALT、AST/ALT、TBil、Alb、肌酐(Cr)、总胆固醇(TC)、甘油三酯(TG)、钠(Na)、AFP、血清铁...

     

  • [1] LI LJ, DUAN ZP.Diagnostic and treatment guidelines for liver failure (2012 version) [J].Chin J Clin Infect Dis, 2012, 5 (6) :321-327. (in Chinese) 李兰娟, 段钟平.肝衰竭诊治指南 (2012年版) [J].中华临床感染病杂志, 2012, 5 (6) :321-327.
    [2]SARIN SK, KEDARISETTY CK, ABBAS Z, et al.Acute-onchronic liver failure:Consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014[J].Hepatol Int, 2014, 8 (4) :453-471.
    [3]WLODZIMIROW KA, ESLAMI S, ABU-HANNA A, et al.Asystematic review on prognositc indicators of acute on chronic liver failure and their predictive value for mortality[J].Liver Int, 2013, 33 (1) :40-52.
    [4]CHENG XP, ZHAO J, CHEN Y, et al.Comparison of the ability of the PDD-ICG clearance test, CTP, MELD, and MELD-Na to predict shot-term and medium-term mortality in patients with decompensated hepatitis B cirrhosis[J].Eur JGastroenterol Hepatol, 2016, 28 (4) :444-448.
    [5]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[J].Gastroenterology, 2013, 144 (7) :1426-1437.
    [6]DING R, ZHAO H, WANG Q, et al.Prognostic value of low triiodothyronine syndrome on short-term prognosis of patients with acute-on-chronic liver failure[J/CD].Chin J Liver Dis:Electronic Edition, 2018, 10 (4) :90-95. (in Chinese) 丁蕊, 赵红, 王琦, 等.低三碘甲腺原氨酸综合征对慢加急性肝衰竭患者短期预后的预测价值[J/CD].中国肝脏病杂志:电子版, 2018, 10 (4) :90-95.
    [7]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.
    [8]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.
    [9]WIESNER R, EDWARDS E, FREEMAN R, et al.Model for end-stage liver disease (MELD) and allocation of donor livers[J].Gastroenterology, 2003, 124 (1) :91-96.
    [10]ZHANG H, JIA L, YAO SW, et al.Value of MELD combined with serum sodium concentration in predicting the short-term outcome of patients with HBV-related acute-on-chronic liver failure in China:A meta-analysis[J].J Clin Hepatol, 2018, 34 (9) :1950-1955. (in Chinese) 张辉, 贾雷, 姚士伟, 等.MELD-Na评分对我国HBV相关慢加急性肝衰竭短期预后预测价值的Meta分析[J].临床肝胆病杂志, 2018, 34 (9) :1950-1955.
    [11]BIGGINS SW, KIM WR, TERRAULT NA, et al.Evidencebased incorporation of serum sodium concentration into MELD[J].Gastroenterology, 2006, 130 (6) :1652-1660.
    [12]DUSEIA A, CHOUDHARV NS, GUPTA S, et al.APACHEⅡscore 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]AQRAWAL S, DUSEIA A, GUPTA T, et al.Simple organ failure count versus CANONIC grading system for predicting mortality in acute-on-chronic liver failure[J].J Gastroenterol Hepatol, 2015, 30 (3) :575-581.
    [14]KEDARISETTY CK, ANAND L, BHARDW-AJ A, et al.Combinaton of granulocyte colony-stimulating factor and erythropoietin improves outcomes of patients with decompensated cirrhosis[J].Gastroenterology, 2015, 148 (7) :1362-1370.
    [15]ROUILLARD SS, BASS NM, ROBERTS JP, et al.Severe hyperbilirubinemia after creation of transjugular intrahepatic portosystemic shunts:Natural history and predictors of outcome[J].Ann Int Med, 1998, 128 (5) :374-377.
    [16]CONN HO.A peek at the Child-Turcotte classification[J].Hepatology, 1981, 1:673-676.
    [17]YANG MY, LI B, DING HG.The effects of liver disease on endocrine hormone[J].Chin J Hepatol, 2014, 22 (3) :168-170. (in Chinese) 杨梦媛, 李冰, 丁惠国.肝脏疾病对内分泌激素的影响[J].中华肝脏病杂志, 2014, 22 (3) :168-170.
    [18]LI WY, ZHANG MX, QI TT, et al.The potential factors contributing to thrombocytopenia in acute on chronic liver failure patients[J].Chin Hepatol, 2015, 20 (6) :457-461. (in Chinese) 李文燕, 张明霞, 祁婷婷, 等.慢加急性肝衰竭患者血小板减少的可能原因[J].肝脏, 2015, 20 (6) :457-461.
  • 加载中
计量
  • 文章访问数:  1322
  • HTML全文浏览量:  55
  • PDF下载量:  296
  • 被引次数: 0
出版历程
  • 收稿日期:  2019-01-22
  • 出版日期:  2019-06-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回