血清降钙素原和ASS评分对慢加急性肝衰竭患者短期预后的评价  

Short-term prognostic value of serum procalcitonin and ASS score in patients with acute-on-chronic liver failure

作　　者：董飞波 高国生[1] 胡爱荣[1] 祝成亮[2] 

机构地区：[1]宁波市第二医院,浙江宁波315010 [2]武汉大学人民医院,湖北武汉430060

出　　处：《中国卫生检验杂志》2015年第5期613-615,共3页Chinese Journal of Health Laboratory Technology

基　　金：国家973计划(2012CB518900);宁波市科技局社会发展项目(2009C50025);吴阶平医学基金会肝病医学部肝功能评价方法研究基金(LDWMF-PJ-2011A003)

摘　　要：目的 探讨血清降钙素原（PCT）和修正全身炎症反应综合征（ASS）评分单独和联合应用对慢加急性肝衰竭患者短期（3个月）预后的预测价值。方法 72例慢加急性肝衰竭患者分成生存组和死亡组,记录入院时的ASS评分,并检测血清PCT,应用受试者工作特征曲线（ROC）下面积评价PCT、ASS评分单项及联合应用对疾病预后的预测价值。结果 生存组患者PCT浓度、ASS评分分别为0.47 ng/ml±0.36 ng/ml、（5.25±2.72）分,而死亡组分别为1.31 ng/ml±1.27 ng/ml、（7.90±3.04）分,差异均有统计学意义（P〈0.01）;死亡率随PCT浓度和ASS评分的增加而升高（P〈0.01）。PCT、ASS评分的ROC曲线下面积分别为0.775（0.661-0.865）、0.808（0.698-0.918）,差异无统计学意义（P〉0.05）。对PCT、ASS评分等进行多因素Logistic回归分析,联合预测因子的ROC曲线下面积达到0.870。结论 血清降钙素原和ASS评分均可用于慢加急性肝衰竭患者短期临床预后的预测,两者的联合运用可有效提高预测的准确性。Objective To explore the short-term（ 3 months） prognostic value of serum procalcitonin（ PCT） and ASS score alone or combined in patients with acute-on-chronic liver failure. Methods 72 patients with acute-on-chronic liver failure were divided into survival group and dead group. The patients＇ ASS score was recorded when hospitalized and serum PCT was detected. The prognostic value of the serum PCT and ASS score alone or combined using receiver operating characteristic curves（ ROC） was assessed in patients with acute-on-chronic liver failure. Results The serum concentration of PCT and ASS score were 0. 47 ng / ml ± 0. 36 ng / ml and 5. 25 ± 2. 72 respectively in survival group,while that were 1. 31 ng / ml ±1. 27 ng / ml and 7. 90 ± 3. 04 respectively in dead group. The difference had statistically significance（ P 0. 01） and the death rate elevated with the increasing of serum concentration of PCT and ASS score（ P 0. 01）. The area under the curve of PCT and ASS score was 0. 775（ 0. 661-0. 865） and 0. 808（ 0. 698-0. 918） respectively,and there was no statistical significance for the difference between 2 groups（ P 0. 05）. The area under the curve of combined predictor established from serum PCT and ASS score by multivariate logistic regression analysis was 0. 870. Conclusion Serum procalcitonin and ASS score can be used to predict the short-term prognosis of patients with acute-on-chronic liver failure,and the accuracy of prediction could be effectively improved by the combination of them.

关 键 词：慢加急性肝衰竭 降钙素原 修正全身炎症反应综合征评分 预后 

分 类 号：R575.3[医药卫生—消化系统]