摘要
目的:分析终末期肝病模型(MELD)评分系统在肝硬化失代偿期对短期和中期预后判断的作用。方法:92例各种病因的肝硬化失代偿患者,分别计算每例患者的MELD评分,同时计算其Child-Turcotte-Pugh(CTP)评分,并随访3个月及1年的生存率。并以受试者工作曲线(ROC)下面积衡量MELD、CTP评分预测患者预后的能力。结果:92例患者随访3个月内有11例患者死亡,死亡组MELD(22.9±5.40)、CTP(11.4±2.67)与生存组比较差异均有统计学意义(P<0.05);随访1年内有21例患者死亡,死亡组MELD(19.6±8.69)、CTP(10.9±2.84)与生存组比较差异有统计学意义(P<0.01);MELD、CTP评分对3个月预后评估的ROC曲线面积分别为0.782,0.721;对1年预后评估的ROC曲线下面积为0.747,0.705。结论:MELD评分能很好地预测肝硬化患者的短期和中期预后,其评估价值至少不亚于CTP评分,但其客观性要强于CTP评分,值得临床推广应用。
Objective：To evaluate the short and medium term survival prognosis of patients with decompensated liver cirrhosis by means of model for end-stage liver disease（MELD）.Methods：Ninty-two patients with decompensated liver cirrosis were analyzed.MELD score and Child-Turcotte-Pugh score were calculated for each patient on the first day,than evaluated survival of those patients with three months and one year.The predictive value related with MELD and CTP scores was determined by the area under receiver operating characteristic（ROC） curve.Results：Eleven patients died within 3 months,the MELD（22.9±5.40） and CTP（11.4±2.67）levels were higher than those survivors（P〈0.01）.Twenty-one patients died within one year,the MELD（19.6±8.69） and CTP（10.9±2.84）were higher than those survivors（P〈0.01）.For 3 month predictive prognosis,the area under ROC of MELD,CTP were 0.782 and 0.721,respectively.For one year predicive prognosis,the area under ROC of MELD,CTP were 0.747 and 0.705.Conclusion：MELD score is an excellent predictor of both short and medium term survival,and performs at least as well as the Child-Pugh score.
出处
《中国临床医学》
北大核心
2008年第3期352-354,共3页
Chinese Journal of Clinical Medicine
