血浆渗透压与肝肾综合征预后的关系  

Relationship between plasma osmotic pressure and the prognosis of patients with hepatorenal syndrome

作　　者：崔海彬[1] 崔速南[1] 汪明明[1] 张秀珍[1] 刘葵花[1] 郭楠[1] 

机构地区：[1]山东大学医学院济南市传染病医院肝病科,山东济南250012

出　　处：《中国现代医学杂志》2011年第29期3686-3689,共4页China Journal of Modern Medicine

摘　　要：目的探讨血浆渗透压评分对肝肾综合征(HRS)预后的评价作用。方法研究对象为106例HRS患者,按随访3月内的预后情况分为生存组(30例)和死亡组(76例),分别进行血浆有效晶体渗透压评分、胶体渗透压评分、血浆渗透压综合评分、MELD及Child-Pugh评分,进行统计学分析,比较各评分对HRS预后的评价能力。结果 HRS死亡组除血浆有效晶体渗透压单项评分外,其余各评分均高于存活组(P<0.01)。血浆有效晶体渗透压单项评分和胶体渗透压单项评分的AUC均<0.7,Child-Pugh评分、MELD评分和血浆渗透压综合评分的AUC均>0.7。Youden指数以血浆渗透压综合评分为最高,MELD评分和Child-Pugh评分次之。结论 Child-Pugh评分、MELD评分和血浆渗透压综合评分对HRS预后均具有良好的评价作用,其中以血浆渗透压综合评分的预测能力最佳。[ Objective ] To investigate the role of plasma osmotic pressure score in predicting the prognosis of patients with hepatorenal syndrome （HRS）. [Methods] One hundred and six patients were enrolled in the study, whom were divided into survival group （30 cases） and death group （76 eases） by the prognosis in the three months follow-up. The five scores including effective crystal osmotic pressure score, colloid osmotic pressure score, plasma osmotic pressure comprehensive score, MELD score and Child-Pugh score were applied, and the capability of these five scores to predict the prognosis of HRS were compared. [ Results] The scores of death group evaluated by these five scores except effective crystal osmotic pressure score were sig- nificantly higher than those of survival group （P〈0.01）. The AUC values of effective crystal osmotic pressure score and colloid osmotic pressure score were less than 0.7, others were more than 0.7. Plasma osmotic pres- sure comprehensive score had the highest Youden＇s indexes, followed by the MELD and Child-Pugh score. [Conclusions] Plasma osmotic pressure comprehensive score, MELD and Child-Pugh score can successfully predict the prognosis of HRS, and plasma osmotic pressure comprehensive score shows the best correlation with the prognosis.

关 键 词：肝肾综合征 肝硬化 血浆渗透压评分 CHILD-PUGH评分 MELD评分 

分 类 号：R575.2[医药卫生—消化系统]