终末期肝病模型及Child-Pugh分级对失代偿期肝硬化患者的预后分析

占国清; 郑三菊; 朱琳; 王崇慧; 李金科; 张薇薇

摘要: 目的探讨终末期肝病模型（MELD）及Child-Pugh评分对失代偿期肝硬化预后评估的应用价值。方法应用MELD评分公式及Child-Pugh分级对136例失代偿期肝硬化患者进行评分及分级,比较两种系统对肝硬化预后的评估。结果分别有19.85%和33.82%患者3个月和6个月内死亡,死亡组MELD和Child-Pugh评分均高于生存组（P<0.001）;MELD评分在3个月预后评估的ROC曲线AUC高于Child-Pugh评分（P<0.05）;生存分析表明MELD与Child-Pugh评分均可有效地分辨6个月内可能生存及死亡的患者（P<0.005）;MELD评分与Child评分显著相关（r=0.67,P<0.001）。结论MELD评分及Child-Pugh评分均可预测失代偿期肝硬化患者短期预后,MELD评分短期评估优于Child-Pugh分级。

关键词:

Abstract: Objective To investigate the prognosis value of the Model for End-stage Liver Disease (MELD) and Child-Pugh grading in patients with decompensated liver cirrhosis.Methods 136 patients with decompensated liver cirrhosis were graded with MELD formula and with Child-Pugh, and the prognosis value were compared.Results 19.85% and 33.82% of the died within three and six month term respectively, MELD and Child-Pugh score for deaths were higher than those for survivors significantly (P<0.001) .Area under the ROC of MELD was higher than that of Child-Pugh for three month term (P<0.05) .Survival analysis showed MELD and Child-Pugh grading could clearly discriminate between patients who survived or died in six month term (P<0.005) .MELD values had significant correlation with Child-Pugh scores (r=0.67, P<0.001) .Conclusion Both MELD and Child-Pugh scores can accurately predict the short-term prognosis of patients with decompensated liver cirrhosis, MELD grading is more efficient than Child-Pugh score for short-term prognosis.

Key words:

Decompensated liver cirrhosis /
Model for End-stage Liver Disease scoring /
Child-Pugh grading /
Prognosis

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终末期肝病模型及Child-Pugh分级对失代偿期肝硬化患者的预后分析

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The analysis of prognosis of patients with decompensated liver cirrhosis using the criterion of the model for end-stage liver disease and Child-Pugh grading

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终末期肝病模型及Child-Pugh分级对失代偿期肝硬化患者的预后分析

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The analysis of prognosis of patients with decompensated liver cirrhosis using the criterion of the model for end-stage liver disease and Child-Pugh grading

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