终末期肝病模型对重型肝炎预后的评价研究  

Finally last stage liver disease model to heavy hepatitis prognosis evaluation study

作　　者：刘华生[1] 杜文杰[1] 陈亚岗[2] 

机构地区：[1]舟山市人民医院感染科,316000 [2]浙江大学医学院附属第一医院感染科

出　　处：《浙江医学》2011年第4期525-528,共4页Zhejiang Medical Journal

摘　　要：目的 探讨终末期肝病模型（MELD）对重型肝炎预后的评估价值.方法 整理250例重型肝炎的患者临床资料,并进行MELD评分,以评估重型肝炎的严重程度和预后 同时比较MELD评分、CTP评分、PTA评分三者对重型肝炎预后预测的准确率.结果 重型肝炎恶化死亡组患者MELD评分分值明显高于存活组（P＜0.01） 当MELD分值≥40时,89.0%患者病情恶化而死亡,MELD分值≥30时,68.0%患者恶化死亡 PTA评分＜20%时,91.9%患者死亡,PTA＜30%时,74.0%患者死亡 CTP评分＞12时,预后预测准确率为52.4%,当CTP＞10分时,准确率为52.0%.结论 MELD评分系统在国内是适用的 重型肝炎患者MELD分值与病情严重程度和预后正相关,MELD模型与PTA对重肝预后预测的准确性优于CTP评分.Objective To study the evaluation of Model for end-stage liver disease system to asses the prognosis of patients with severe hepatitiso Methods The clinical data of 250 patients with severe hepatitis were collected and evaluated by MELD scoring system to asses the severe hepatitis patient＇s condition and prognosis;and compare the capability in predicting the prognosis of severe hepatitis among 3 prediction systems：Model for end-stage liver disease system,Child-Turcotte-Pugh system and PTAo Results The MELD scores of the dead group were higher remarkable than those of the surviving group （P 〈 0.01 ）,The scores of MELD had positive correlation with the actual fatality rate,when the scores of MELD =〉 40, 89.0 percents of the patients were deteriorated, when the scores of MELD =〉 30, 68.0 percents were deteriorated ;when the PTA 〈 20%, 91.9 percents were deteriorated and when PTA 〈 30%,74.0 percents were deterioratedo Conclusions MELD scoring system can be popu- larized in our country. The score of MELD in severe hepatitis are correlated to the patient＇s condition and prognosiso The predictive capability of MELD system and PTA is better than CTP system.

关 键 词：重型肝炎 预后 评价研究 MELD评分 CTP评分 

分 类 号：R575[医药卫生—消化系统]