经颈静脉肝内门体分流术预后模型的研究现状

李慧; 夏志波; 肖年军; 褚建国; 宁守斌; 韩者艺

doi:10.3969/j.issn.1001-5256.2023.05.030

经颈静脉肝内门体分流术预后模型的研究现状

DOI: 10.3969/j.issn.1001-5256.2023.05.030

空军特色医学中心消化内科，北京 100142

基金项目:

国家自然科学基金 (81873562)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：李慧负责课题设计，资料分析，撰写论文，修改论文；夏至波、肖年军参与收集数据；韩者艺、宁守斌、褚建国负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
韩者艺，zheyihan_fmmu@163.com (ORCID：0000-0002-0651-9810)

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出版历程
- 收稿日期: 2022-09-18
- 录用日期: 2022-11-21
- 出版日期: 2023-05-20

Current research status of prognostic models for transjugular intrahepatic portosystemic shunt

Department of Gastroenterology, Air Force Medical Center, Beijing 100142, China

Research funding:

National Natural Science Foundation of China (81873562)

More Information

Corresponding author: HAN Zheyi, zheyihan_fmmu@163.com (ORCID: 0000-0002-0651-9810)

摘要

摘要: 经颈静脉肝内门体分流术(TIPS)是治疗失代偿期肝硬化门静脉高压并发症的一种安全有效的方法。目前存在多种预后评分工具用于TIPS不良预后的危险分层。简述了当前临床中应用较多的7种TIPS预后评分工具，并总结了每种评分工具的相关临床研究证据。通过文献综述表明，当前尚无充分研究证据能够明确TIPS的最优预后评分工具。未来临床研究应更全面地探究不同评分工具对TIPS近期及远期不良预后事件预测能力的优劣，以及结合新的预后相关标志物开发新的预后评分工具。
- 门体分流术, 经颈静脉肝内 /
- 肝硬化 /
- 预后 /
- 模型，统计学
Abstract: Transjugular intrahepatic portosystemic shunt (TIPS) is a safe and effective method for the treatment of portal hypertension complications in patients with decompensated liver cirrhosis. At present, there are many prognostic scoring tools for risk stratification of poor prognosis after TIPS. This article briefly introduces seven prognostic scoring tools commonly used for TIPS and summarizes the clinical research evidence of each scoring tool. The literature review shows that there is currently no sufficient research evidence to determine the optimal prognostic scoring tool after TIPS. Future clinical studies should comprehensively explore the advantages and disadvantages of different scoring tools in predicting short- and long-term adverse prognostic events after TIPS and develop new prognostic scoring tools in combination with new prognostic markers.
- Portasystemic Shunt, Transjugular Intrahepatic /
- Liver Cirrhosis /
- Prognosis /
- Models, Statistical

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参考文献(39)

[1]	ROSSLE M. TIPS: 25 years later[J]. J Hepatol, 2013, 59(5): 1081-1093. DOI: 10.1016/j.jhep.2013.06.014.
[2]	BETTINGER D, SCHULTHEISS M, BOETTLER T, et al. Procedural and shunt-related complications and mortality of the transjugular intrahepatic portosystemic shunt (TIPSS)[J]. Aliment Pharmacol Ther, 2016, 44(10): 1051-1061. DOI: 10.1111/apt.13809.
[3]	LEE EW, KUEI A, SAAB S, et al. Nationwide trends and predictors of inpatient mortality in 83884 transjugular intrahepatic portosystemic shunt[J]. World J Gastroenterol, 2016, 22(25): 5780-5789. DOI: 10.3748/wjg.v22.i25.5780.
[4]	SALERNO F, MERLI M, CAZZANIGA M, et al. MELD score is better than Child-Pugh score in predicting 3-month survival of patients undergoing transjugular intrahepatic portosystemic shunt[J]. J Hepatol, 2002, 36(4): 494-500. DOI: 10.1016/s0168-8278(01)00309-9.
[5]	ALLEGRETTI AS, FRENK NE, LI DK, et al. Evaluation of model performance to predict survival after transjugular intrahepatic portosystemic shunt placement[J]. PLoS One, 2019, 14(5): e0217442. DOI: 10.1371/journal.pone.0217442.
[6]	SARWAR A, ZHOU L, NOVACK V, et al. Hospital volume and mortality after transjugular intrahepatic portosystemic shunt creation in the United States[J]. Hepatology, 2018, 67(2): 690-699. DOI: 10.1002/hep.29354.
[7]	JIANG ZS, JIANG JN. The progress of evaluating the liver store function of the End-stage Liver Disease[J]. Med Recapitulate, 2006, 17: 1075-1077. DOI: 10.3969/j.issn.1006-2084.2006.17.025. 蒋忠胜, 江建宁. 评价终末期肝病肝脏储备功能的进展[J]. 医学综述, 2006, 17: 1075-1077. DOI: 10.3969/j.issn.1006-2084.2006.17.025.
[8]	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. DOI: 10.1002/bjs.1800600817.
[9]	BANARES R, CASADO M, RODRIGUEZ-LAIZ JM, et al. Urgent transjugular intrahepatic portosystemic shunt for control of acute variceal bleeding[J]. Am J Gastroenterol, 1998, 93(1): 75-79. DOI: 10.1111/j.1572-0241.1998.075_c.x.
[10]	JALAN R, ELTON RA, REDHEAD DN, et al. Analysis of prognostic variables in the prediction of mortality, shunt failure, variceal rebleeding and encephalopathy following the transjugular intrahepatic protosystemic stent-shunt for variceal haemorrhage[J]. J Hepatol, 1995, 23(2): 123-128. DOI: 10.1016/0168-8278(95)80325-4.
[11]	YUAN SS, HAN GH, FAN DM. TIPS treatment of the complications of portal hypertension: the current status of its prognostic evaluation[J]. J Intervent Radiol, 2011, 20(3): 245-248. DOI: 10.3969/j.issn.1008-794X.2011.03.018. 原姗姗, 韩国宏, 樊代明. TIPS治疗门静脉高压并发症预后评价的现状[J]. 介入放射学杂志, 2011, 20(3): 245-248. DOI: 10.3969/j.issn.1008-794X.2011.03.018.
[12]	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. DOI: 10.1053/jhep.2001.22172.
[13]	KIM HJ, LEE HW. Important predictor of mortality in patients with end-stage liver disease[J]. Clin Mol Hepatol, 2013, 19(2): 105-115. DOI: 10.3350/cmh.2013.19.2.105.
[14]	MALINCHOC M, KAMATH PS, GORDON FD, et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts[J]. Hepatology, 2000, 1: 864-871. DOI: 10.1053/he.2000.5852.
[15]	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. DOI: 10.1053/jhep.2001.22172.
[16]	ZHOU CZ, HOU CL, CHENG DL, et al. Predictive accuracy comparison of MELD and Child-Turcotte-Pugh scores for survival in patients underwent TIPS placement: a systematic meta-analytic review[J]. Int J Clin Exp Med, 2015, 8(8): 13464-13472.
[17]	BIGGINS SW, KIM WR, TERRAULT NA, et al. Evidence-based incorporation of serum sodium concentration into MELD[J]. Gastroenterol, 2006, 130(6): 1652-1660
[18]	GUY J, SOMSOUK M, SHIBOSKI S, et al. New model for end stage liver disease improves prognostic capability after transjugular intrahepatic portosystemic shunt[J]. Clin Gastroenterol Hepatol, 2009, 7(11): 1236-1240. DOI: 10.1016/j.cgh.2009.06.009.
[19]	AHMED R, SANTHANAM P, RAYYAN Y. MELD-Na as a prognostic indicator of 30-and 90-day mortality in patients with end-stage liver disease after creation of transjugular intrahepatic portosystemic shunt[J]. Eur J Gastroenterol Hepatol, 2015, 27(10): 1226-1227. DOI: 10.1097/MEG.0000000000000412.
[20]	HEUMAN DM, ABOU-ASSI SG, HABIB A, et al. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death[J]. Hepatology, 2004, 40: 802-810. DOI: 10.1002/hep.20405.
[21]	RUF AE, KREMERS WK, CHAVEZ LL, et al. Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone[J]. Liver Transpl, 2005, 11: 336-343. DOI: 10.1002/lt.20329.
[22]	GINES P, ARROYO V, QUINTERO E, et al. Comparison of paracentesis and diuretics in the treatment of cirrhotics with tense ascites. Results of a randomized study[J]. Gastroenterology, 1987, 93: 234-241. DOI: 10.1016/0016-5085(87)91007-9.
[23]	JOHNSON PJ, BERHANE S, KAGEBAYASHI C, et al. Assessment of liver function in patients with hepatocellular carcinoma: A new evidence-based approach-the ALBI grade[J]. J Clin Oncol, 2015, 33(6): 550-558. DOI: 10.1200/JCO.2014.57.9151.
[24]	RONALD J, WANG Q, CHOI SS, et al. Albumin-bilirubin grade versus MELD score for predicting survival after transjugular intrahepatic portosystemic shunt (TIPS) creation[J]. Diagn Interv Imaging, 2018, 99(3): 163-168. DOI: 10.1016/j.diii.2017.10.008.
[25]	ROAYAIE S, JIBARA G, BERHANE S, et al. 851 PALBI-An objective score based on platelets, albumin bilirubin stratifies HCC patients undergoing resection & ablation better than child's classification[J]. Hepatology, 2015, 62(Suppl 1): 624A-690A. DOI: 10.1002/hep.28219.
[26]	OIKONOMOU T, GOULIS L, DOUMTSIS P, et al. ALBI and PALBI grades are associated with the outcome of patients with stable decompensated cirrhosis[J]. Ann Hepatol, 2019, 18(1): 126-136. DOI: 10.5604/01.3001.0012.7904.
[27]	ELSHAARAWY O, ALLAM N, ABDELSAMEEA E, et al. Platelet-albumin-bilirubin score-a predictor of outcome of acute variceal bleeding in patients with cirrhosis[J]. World J Hepatol, 2020, 12(3): 99-107. DOI: 10.4254/wjh.v12.i3.99.
[28]	KHABBAZ RC, LOKKEN RP, CHEN YF, et al. Albumin-Bilirubin and Platelet-Albumin-Bilirubin grades do not predict survival after transjugular intrahepatic portosystemic shunt creation[J]. Cardiovasc Intervent Radiol, 2018, 41(7): 1029-1034. DOI: 10.1007/s00270-018-1923-2
[29]	JALAN R, PAVESI M, SALIBA F, et al. The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure[J]. J Hepatol, 2015, 62(4): 831-840. DOI: 10.1016/j.jhep.2014.11.012
[30]	STURM L, PRAKTIKNJO M, BETTINGER D, et al. Prognostic value of the CLIF-C AD score in patients with implantation of transjugular intrahepatic portosystemic shunt[J]. Hepatol Commun, 2021, 5(4): 650-660. DOI: 10.1002/hep4.1654.
[31]	BETTINGER D, STURM L, PFAFF L, et al. Refining prediction of survival after TIPS with the novel Freiburg index of post-TIPS survival[J]. J Hepatol, 2021, 74(6): 1362-1372. DOI: 10.1016/j.jhep.2021.01.023.
[32]	CHAPIN SE, GOLDBERG DS, KAPLAN DE, et al. External validation of the FIPS score for post-TIPS mortality in a national veterans affairs cohort[J]. Dig Dis Sci, 2021, 67(9): 4581-4589. DOI: 10.1007/s10620-021-07307-5.
[33]	YANG CT, CHEN QY, ZHOU C, et al. FIPS score for prediction of survival after TIPS placement: external validation and comparison with traditional risk scores in a cohort of Chinese patients with cirrhosis[J]. AJR Am J Roentgenol, 2022, 219(2): 255-267. DOI: 10.2214/AJR.21.27301.
[34]	LIU SY, LI LH, LI SX, et al. Predictive value of controlled nutritional status score for overt hepatic encephalopathy after transjugular intrahepatic portosystemic stent-shunt of Budd-Chiari syndrome[J]. Chin J Dig Surg, 2023, 22(2): 260-267. DOI: 10.3760/cma.j.cn115610-20221205-00733. 刘胜炎, 李路豪, 李素新, 等. 控制营养状况评分对布-加综合征患者行经颈静脉肝内门腔内支架分流术后发生显性肝性脑病的预测价值[J]. 中华消化外科杂志, 2023, 22(2): 260-267. DOI: 10.3760/cma.j.cn115610-20221205-00733.
[35]	GABA RC, COUTURE PM, BUI JT, et al. Prognostic capability of different liver disease scoring systems for prediction of early mortality after transjugular intrahepatic portosystemic shunt creation[J]. J Vasc Interv Radiol, 2013, 24(3): 411-420. e1-4;quiz 421. DOI: 10.1016/j.jvir.2012.10.026.
[36]	ZHANG YF, CHEN P. Prognosis of transjugular intrahepatic portosystemic shunt[J]. Chin J Min Inv Surg, 2018, 18(5): 457-461. DOI: 10.3969/j.issn.1009-6604.2018.05.019. 张艳飞, 陈平. 经颈静脉肝内门体静脉分流术的预后研究进展[J]. 中国微创外科杂志, 2018, 18(5): 457-461. DOI: 10.3969/j.issn.1009-6604.2018.05.019.
[37]	PRAKTIKNJO M, BOOK M, LUETKENS J, et al. Fat-free muscle mass in magnetic resonance imaging predicts acute-on-chronic liver failure and survival in decompensated cirrhosis[J]. Hepatology, 2018, 67(3): 1014-1026. DOI: 10.1002/hep.29602.
[38]	ZHANG BT, XU Y, YANG XF, et al. Association of sarcopenia with prognosis after transjugular intrahepatic portosystemic shunt in patients with liver cirrhosis[J]. J Clin Hepatol, 2021, 37(12): 2932-2934. DOI: 10.3969/j.issn.1001-5256.2021.12.041. 张帮婷, 胥莹, 杨雪芳, 等. 肝硬化肌少症与经颈静脉肝内门体分流术预后的关系[J]. 临床肝胆病杂志, 2021, 37(12): 2932-2934. DOI: 10.3969/j.issn.1001-5256.2021.12.041.
[39]	TONEY LK, VESSELLE HJ. Neural networks for nodal staging of non-small cell lung cancer with FDG PET and CT: importance of combining uptake values and sizes of nodes and primary tumor[J]. Radiology, 2014, 270(1): 91-98. DOI: 10.1148/radiol.13122427.