白蛋白-胆红素评分在自身免疫性肝炎肝硬化预后评估中的应用  

Albumin-to-bilirubin scores for assessing the prognosis in autoimmune hepatitis-related cirrhosis

作　　者：宋岩 杨虎 林琳[3] 姜葵[1] 刘文天[1] 王邦茂[1] 林睿[1] Song Yan;Yang Hu;Lin Lin;Jiang Kui;Liu Wentian;Wang Bangmao;Lin Rui(Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China;Department of Nephrology, Tianjin Medical University NO.2 Hospital, Tianjin 300211, China;Department of Internal Medicine, Tianjin Medical University General Hospital Airport Hospital, Tianjin 300308)

机构地区：[1]天津医科大学总医院消化内科,300052 [2]天津医科大学第二医院肾内科,300211 [3]天津医科大学总医院空港医院综合内科,300308

出　　处：《中华肝脏病杂志》2019年第10期772-776,共5页Chinese Journal of Hepatology

基　　金：国家自然科学基金青年科学基金(81600509);天津医科大学总医院青年孵育基金(ZYYFY2016020).

摘　　要：目的探讨白蛋白-胆红素(ALBI)评分在自身免疫性肝炎肝硬化预后评估中的价值。方法采用受试者工作特征曲线评估ALBI、Child-Pugh和终末期肝病模型评分对预后预测的准确性。根据ALBI分级进行生存分析。对ALBI评分及Child-Pugh评分进行Spearman相关分析。采用Kaplan-Meier法绘制生存曲线,用Log-rank方法比较不同组间生存曲线差异。结果共纳入149例患者。受试者工作曲线显示ALBI评分(0.861,0.826,0.779,0.744)对6、12、24、36个月病死预测的准确性高于Child-Pugh评分(0.703,P = 0.006;0.672,P < 0.001;0.613,P < 0.001;0.583,P < 0.001)和终末期肝病模型评分(0.774,P = 0.031;0.731,P = 0.007;0.669,P < 0.001;0.631,P < 0.001)。ALBI 3级患者生存率显著低于ALBI 1级和2级患者。结论ALBI评分可用于评价自身免疫性肝炎肝硬化患者的远期预后。Objective To investigate the prognostic value of albumin-to-bilirubin scores in the assessment of autoimmune hepatitis-related cirrhosis. Methods The receiver operating characteristic curve was used to evaluate the accuracy of ALBI, Child-Pugh and model for end-stage liver disease (MELD) for prognosis prediction. Survival analysis was performed according to the ALBI classification. Spearman correlation analysis was performed on the ALBI score and the Child-Pugh score. Survival curves were plotted by Kaplan-Meier method, and Log-rank method was used to compare the survival difference curves between different groups. Results 149 patients were recruited in the study. The ROC analysis showed that the ALBI scores (0.861, 0.826, 0.779, 0.744)was superior to Child-Pugh scores(0.703, P = 0.006;0.672, P < 0.001;0.613, P < 0.001;0.583, P < 0.001)and MELD score(0.774, P = 0.031;0.731, P = 0.007;0.669, P < 0.001;0.631, P < 0.001) for predicting 6, 12, 24, and 36 months mortality. Patients with ALBI grade 3 had a significantly lower survival rate than those with ALBI grade1 and grade 2. Conclusion ALBI score may be useful to evaluate the long-term prognosis of patients with autoimmune hepatitis-related cirrhosis.

关 键 词：肝硬化 肝炎 自身免疫性 白蛋白-胆红素评分 

分 类 号：R575[医药卫生—消化系统]