摘要
目的探讨FibroScan肝脏硬度值(LSM)测定对乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)患者短期预后的预测价值。方法收集2019年10月至2021年12月在麻城市人民医院感染科住院的80例HBV-ACLF患者作为研究对象,根据出院随访12周的预后情况将其分为预后良好组(38例)及预后不良组(42例)。检测两组的各项指标,计算终末期肝病模型(MELD)评分。分析影响HBV-ACLF患者短期预后的因素、LSM与MELD评分的相关性及LSM、MELD评分、LSM联合MELD评分对HBV-ACLF短期不良预后的预测价值。结果两组患者的性别、年龄、血小板计数(PLT)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、Na+、甲胎蛋白(AFP)比较,差异无统计学意义(P>0.05);两组的白细胞计数(WBC)、总胆红素(TBIL)、直接胆红素(DBIL)、血清肌酐(Scr)、凝血酶原时间(PT)、国际标准化比值(INR)、LSM、MELD评分比较,差异具有统计学意义(P<0.05)。LSM、MELD评分是HBV-ACLF短期预后的影响因素(P<0.05)。LSM与MELD评分呈正相关(r=0.564,P<0.05)。LSM联合MELD评分的预测效能优于LSM及MELD评分,差异具有统计学意义(P<0.05)。结论LSM与HBV-ACLF患者的短期预后具有相关性,LSM联合MELD评分可用于该患者短期不良预后的评估,有较高的灵敏度及特异度,具有一定的应用价值。
Objective To explore the predictive value of FibroScan liver stiffness measurement(LSM)for short-term prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods A total of 80 patients with HBV-ACLF who hospitalized in the infectious disease department of People's Hospital of Macheng City from October 2019 to December 2021 were collected as the research objects.According to the prognosis of 12 weeks after discharge,the patients were divided into good prognosis group(38 cases)and poor prognosis group(42 cases).The indexes of the two groups were detected,and the model for end-stage liver disease(MELD)score was calculated.The factors affecting the short-term prognosis of HBV-ACLF patients,the correlation between LSM and MELD score,and the predictive value of LSM,MELD score,LSM combined with MELD score for short-term poor prognosis of HBV-ACLF were analyzed.Results There were no significant differences in gender,age,platelet count(PLT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),Na+and alpha fetoprotein(AFP)between the two groups(P>0.05);there were statistically significant differences in the white blood cell count(WBC),total bilirubin(TBIL),direct bilirubin(DBIL),serum creatinine(Scr),prothrombin time(PT),international normalized ratio(INR),LSM and MELD score between the two groups(P<0.05).The LSM and MELD score were the influence factors of short-term prognosis of HBV-ACLF(P<0.05).LSM was positively correlated with MELD score(r=0.564,P<0.05).The predictive efficacy of LSM combined with MELD score was better than that of LSM and MELD score,and the difference was statistically significant(P<0.05).Conclusion LSM is correlated with the short-term prognosis of HBV-ACLF patients.LSM combined with MELD score can be used to evaluate the short-term poor prognosis of patients,with high sensitivity and specificity,and has certain application value.
作者
陶奔
熊蒙
郝厚银
陈敬锋
周逸
TAO Ben;XIONG Meng;HAO Houyin;CHEN Jingfeng;ZHOU Yi(People's Hospital of Macheng City,Macheng 438300,China)
出处
《临床医学研究与实践》
2023年第4期21-24,共4页
Clinical Research and Practice
基金
武汉市第四医院·麻城市人民医院科技人才培育专项科研基金项目(麻医字[2019]30号)。
