摘要
目的分析乙肝相关慢加急性肝衰竭(Hepatitis B virus associated chronic acute liver failure,HBV-ACLF)患者6个月预后影响因素及预后模型的建立。方法以2017年5月-2022年5月新疆医科大学第一附属医院感染中心收治的131例HBV-ACLF患者为研究对象。随访6个月,根据患者预后结果分为死亡组(n=60)和存活组(n=71)。收集患者血常规、肝功能、肾功能及血气指标,采用Logistics回归分析筛选影响HBV-ACLF患者6个月预后的因素,并将筛选的因素使用R 4.3.0软件进行绘制列线图预测模型,绘制校准曲线和受试者工作特征曲线(Receiver operating characteristic,ROC)拟合度及预测效能评估,根据决策曲线评估预测模型的临床适用性。结果二元Logistics回归分析发现,血小板计数、白蛋白及凝血酶原时间是影响HBVACLF患者6个月预后的重要因素,建立的预后模型区分度和校准能力较好。自发性腹膜炎在存活组和死亡组HBV-ACLF患者并发症中占比均最高。结论通过白蛋白,血小板计数和凝血酶原时间建立的预测模型对HBV-ACLF患者6个月预后有较好的预测价值。
Objective To analyze the prognostic factors of Hepatitis B virus associated chronic acute liver failure(HBV-ACLF)patients at 6 months and establish a prognostic model.Methods A total of 131 HBV-ACLF patients admitted to the hospital from May 2017 to May 2022 were studied.The patients were followed up for 6 months and divided into death group(n=60)and survival group(n=71)according to the prognosis.Blood routine,liver function,renal function and blood gas indexes of the patients were collected,and the factors affecting the 6 months prognosis of HBV-ACLF patients were screened by Logistics regression analysis.Besides,the selected factors were mapped with R 4.3.0 software to make a column-line prediction model,calibration curve and subject work characteristic curve to evaluate the fit degree and prediction efficiency.The clinical applicability of the prediction model was evaluated according to the decision curve.Results Binary Logistics regression analysis showed that platelet count,albumin and prothrombin time were important factors affecting the 6 months prognosis of HBV-ACLF patients,and the established prognosis model had good differentiation and calibration ability.The incidence of spontaneous peritonitis in HBVACLF patients was the highest in both survival and death groups.Conclusion The prediction model based on albumin,platelet count and prothrombin time can predict the 6 months prognosis of HBV-ACLF patients.
作者
高冉冉
曹阳
郑嵘炅
张紫怡
杨丽
唐努尔
鲁晓擘
GAO Ranran;CAO Yang;ZHENG Rongjiong;ZHANG Ziyi;YANG Li;TANG Nuer;LU Xiaobo(Center of Emergency Trauma,the First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China;Center of Infection,the First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China;The First College of Clinical Medical,the First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)
出处
《新疆医科大学学报》
CAS
2024年第2期209-215,共7页
Journal of Xinjiang Medical University
基金
国家自然科学基金项目(82060115)
“天山英才”科技创新领军人才项目(2022TSYCLJ0024)。
关键词
乙肝相关慢加急性肝衰竭
白蛋白
血小板计数
凝血酶原时间
预后模型
hepatitis B virus associated chronic acute liver failure(HBV-ACLF)
albumin
platelet count
prothrombin time
prognostic model
