ALBI评分与Child-Pugh评分对肝癌肝切除术后肝衰竭预测的比较  

Albumin-bilirubin score versus Child-Pugh score as predictors of posthepatectomy liver failure inhepatocellular carcinoma patients

作　　者：曾勇超 戴朝六[1] 卜献民[1] 丁宏达[1] 苏洋[1] Zeng Yongchao;Dai Chaoliu;Bu Xianmin;Ding Hongda;Su Yang(Department of Hepatobiliary Surgery, Shengjing Hospital , China Medical University, Shengyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院肝胆外科,沈阳110004

出　　处：《中华普通外科杂志》2019年第8期649-651,共3页Chinese Journal of General Surgery

摘　　要：目的探讨Child-Pugh评分与蛋白质-胆红素(albumin-bilirubin, ALBI)评分对肝癌患者肝切除术后肝衰竭(posthepatectomy liver failure,PHLF)的预测能力。方法回顾性分析2013年9月至2018年9月因肝细胞肝癌(hepatocellular carcinoma, HCC)行肝切除患者的临床资料。运用多因素Logistic回归分析肝衰竭发生的危险因素,通过受试者工作曲线(ROC)比较ALBI评分与Child-Pugh 评分对PHLF的预测能力。结果本研究纳入322例患者,多因素分析显示Child-Pugh评分、ALBI评分、腹水、出血量JCGR15、肝纤维化是PHLF的独立危险因素(P<0. 05)。Child-Pugh评分与ALBI评分预测PHLF的ROC曲线下面积(AUC)分别为0. 621和0.729。ALBI评分的最佳临界值为-2. 74,灵敏度为71. 7%,特异度为71. 4%。结论ALBI评分较Child-Pugh评分对肝癌患者肝切除术后肝衰的预测更为准确。Objective To investigate the perioperative risk factors for posthepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma( HCC). Methods Data of 322 cases of liver resection for HCC were retrospectively analyzed from Sep 2013 to Sep 2018. Logistic regression was used to analyze the risk factors for PHLF. The receiver operating characteristic ( ROC) curve was used to analyze the predictive power of the ALBI score and the Child-Pugh score for PHLF. Results Child-Pugh score, ALBI score,intraoperative bleeding amount, ICG R15 and liver fibrosis, peritoneal effusion were independent factors affecting PHLF of HCC patients (P < 0. 05). ROC analysis of Child-Pugh and ALBI scores predicting PHLF showed that area under the ROC was respectively 0. 621 (95% C/:0. 531 - 0. 712) in the Child-Pugh score and 0. 729 ( 95% CI: 0. 645 - 0. 812 ) in the ALBI score. The best critical value, sensitivity and specificity of PHLF that were predicted by ALBI score were - 2. 74, 71. 7% and 71. 4%, respectively. Conclusions The prognostic power of the ALBI score was greater than that of the Child-Pugh score in predicting PHLF.

关 键 词：癌 肝细胞 肝切除术 肝功能衰竭 

分 类 号：R735.7[医药卫生—肿瘤]