血清降钙素原及炎症指标联合MELD评分对慢加急性肝衰竭患者短期预后的预测价值  

Analysis of the predictive value of serum procalcitonin and inflammatory markers combined with MELD score for short-term prognosis in patients with acute-on-chronic liver failure

作　　者：刘贵章[1] 夏琴 冯霞[1] 李声方[1] 许静[1] 赵登蕴[1] 田庆杰[1] LIU Guizhang;XIA Qin;FENG Xia(Department of Infection,Dongguan Donghua Hospital,Guangdong 523110,China)

机构地区：[1]广东省东莞东华医院感染科,523110

出　　处：《白求恩医学杂志》2019年第6期532-534,共3页Journal of Bethune Medical Science

基　　金：广东省东莞市社会科技一般发展项目(编号:201950715046916)。

摘　　要：目的探讨血清降钙素原(PCT)及炎症指标联合终末期肝病模型(MELD)评分在慢加急性肝衰竭(ACLF)短期预后预测中的应用价值。方法回顾性分析90例ACLF患者3个月的随访资料,根据患者的生存情况,将患者分为生存组与死亡组;根据患者的感染情况,将患者分为感染组与非感染组。分别比较生存组与死亡组、感染组与非感染组间PCT、C反应蛋白(CRP)、T1辅助性细胞/T2辅助性细胞(Th1/Th2)及MELD评分差异,并探讨PCT、CRP、Th1/Th2联合MELD评分对ACLF短期预后的预测作用。结果生存组患者PCT、CRP、Th1/Th2及MELD评分均低于死亡组患者(P<0.05或P<0.01);非感染组患者PCT、CRP、Th1/Th2及MELD评分均低于感染组患者(P<0.01);经Logistics回归分析,PCT、CRP、Th1/Th2及MELD评分对于ACLF患者死亡及感染结局具有显著的预测价值。结论PCT、CRP、Th1/Th2联合MELD评分对于ACLF的短期预后具有明确的预测价值。Objective To evaluate the value of serum procalcitonin(PCT)and inflammatory markers combined with end-stage liver disease(MELD)score in short-term prognosis acute-on-chronic liver failure(ACLF).Methods The three months follow-up data of ninety patients with ACLF were retrospectively analyzed.According to survival conditions the patients were divided into survival group and death group,and according to infection conditions the patients were divided into infection group and non-infection group.The differences of PCT,C-reactive protein(CRP),T1 helper cells/T2 helper cells(Th1/Th2)and MELD scores were compared between the survival group and the death group,the infected group and the non-infected group,respectively,and the predictive effect of PCT,CRP,Th1/Th2 combined MELD score on short-term prognosis of ACLF patients was discussed.Results The PCT,CRP,Th1/Th2 and MELD scores in the survival group were lower than those in the death group(P<0.05 or P<0.01).The PCT,CRP,Th1/Th2 and MELD scores in the non-infected group were lower than those in the infected group(P<0.01).According to logistic regression analysis,the PCT,CRP,Th1/Th2 and MELD scores have significant predictive value for the death and infection outcome of ACLF patients.Conclusion The PCT,CRP,Th1/Th2 combined with MELD score have definite predictive value for the short-term prognosis of ACLF.

关 键 词：血清降钙素原 炎症指标 终末期肝病模型 慢加急性肝衰竭 短期预后 

分 类 号：R575.3[医药卫生—消化系统]