MELD-Na联合血清胆固醇、D-二聚体对肝硬化失代偿期患者预后的判断价值  

Evaluating value of MELD-Na score Combined with serum cholesterol and D-Dimer levels to prognosis in patients with decompensated liver cirrhosis

作　　者：范辉[1] 徐伟松[1] 刘玉峰[1] 王一平[1] 李振东[1] 王申[2] 沈云志[2] 

机构地区：[1]江苏省南通市第二人民医院消化内科,226002 [2]苏州大学附属第三医院消化内科

出　　处：《齐齐哈尔医学院学报》2011年第18期2920-2922,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨MELD-Na评分联合血清胆固醇、D-二聚体浓度对肝硬化失代偿期患者预后的判断价值。方法回顾性分析失代偿期肝硬化住院患者176例,分别根据随访6月、12月及18月的生存、死亡情况分组,通过测定相关指标计算存活组与死亡组患者MELD-Na分值,测定血清胆固醇、D-二聚体浓度,探求MELD-Na分值联合血清胆固醇、D-二聚体浓度与肝硬化失代偿期患者预后相关性。结果随访6月,25例患者死亡;随访12月,59例患者死亡;随访18月,97例患者死亡,存活组与死亡组患者MELD-Na分值、血清胆固醇、D-二聚体浓度之间的差异有统计学意义。ROC判定MELD-Na分值、血清胆固醇、D-二聚体浓度对预测失代偿期肝硬化患者的死亡有很大应用价值。MELD-Na分值预测失代偿期肝硬化患者死亡的最佳临界值为30,MELD-Na分值增高患者死亡风险也增加;血清D-Dimer预测失代偿期肝硬化患者死亡的最佳临界值为1.4mg/L,血清胆固醇预测患者死亡的最佳临界值为≤1.65μmol/L,血清胆固醇、D-二聚体浓度增高可增加患者死亡风险。结论 MELD-Na评分联合血清胆固醇、D-二聚体浓度对肝硬化失代偿期患者预后有较高的判断价值。Objective To evaluate the short and medium term mortality prognosis of a series of cirrhotic patients by means of MELD-Na score combined with serum cholesterol and D-Dimer concentration.Methods A retrospective analysis of 176 hospitalized patients with decompensated liver cirrhosis was conducted.Patients were divided into survival and death group according to follow-ups at 6 months,12 months and 18 months.MELD-Na score and CTP score were made among 176 patients by detecting relevant indicators.Serum cholesterol and D-Dimer concentration were measured.MELD-Na score combined with serum cholesterol and D-Dimer concentration were used to explore the capability which predicting the pre-diagnosis in patients with decompensated liver cirrhosis prognosis.Results Twenty-five patients died at the follow-up for 6 months.Fifty-nine patients died at the followed up for 12 months.Ninety-seven patients died at the followed up for 18 months.MELD-Na score,serum cholesterol and D-Dimer concentration were of statistical significance between the survival group and death group.The ROC curve determine the MELD-Na score,serum cholesterol and D-Dimer were of great value in predicting patients with decompensated liver cirrhosis.The best the critical value of MELD-Na score to predict death in patients with decompensated liver cirrhosis were 30.The risk of death would rise if MELD-Na score increased.The best the critical value of plasma D-Dimer to predict death in patients with decompensated liver cirrhosis were 1.4mg/L.The best threshold values of serum cholesterol to predict death in patients with decompensated liver cirrhosis were less than 1.65μmol/L.The risk of death would rise if serum cholesterol decreased and/or D-Dimer concentration rised.Conclusions MELD-Na score,serum cholesterol and D-Dimer were of higher prognostic value to judge the prognosis of patients with decompensated liver cirrhosis.

关 键 词：肝硬化 胆固醇 D-二聚体 终末期肝病血清钠模型 

分 类 号：R575.2[医药卫生—消化系统]