C反应蛋白/前清蛋白比值结合终末期肝病模型评分对脾切除术后门静脉系统血栓的预测价值  

Predictive value of C-reactive protein/prealbumin ratio combined with end-stage liver disease model score for portal vein thrombosis after splenectomy

作　　者：黄义华[1] 黄平兰 黄菊玲[1] 江新华 袁航 毛卫 HUANG Yihua;HUANG Pinglan;HUANG Juling;JIANG Xinhua;YUAN Hang;MAO Wei(Department of General Surgery,Nanchang Ninth Hospital,Jiangxi Province,Nanchang,330002,China)

机构地区：[1]南昌市第九医院普外科,江西南昌330002

出　　处：《中国当代医药》2022年第33期59-61,65,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220219071)。

摘　　要：目的探讨C反应蛋白/前清蛋白(CRP/PAB)比值结合终末期肝病模型(MELD)评分对脾切除术后门静脉系统血栓(PVT)的预测价值。方法选取2020年1月至2022年3月南昌市第九医院收治的63例肝硬化脾切除患者为研究对象,分析影响术后PVT的相关因素以及CRP/PAB比值结合MELD评分预测术后PVT的价值。结果不同脾质量、CRP/PAB比值、MELD评分的肝硬化脾切除患者PVT发生率比较,差异有统计学意义(P<0.05);ROC曲线显示,CRP/PAB比值预测术后PVT的AUC和截点值分别为0.634、0.38,MELD评分预测术后PVT的AUC和截点值分别为0.852、14.62分,二者联合预测术后PVT的AUC为0.880。结论脾质量、CRP/PAB比值、MELD评分是影响肝硬化脾切除患者术后PVT的相关因素,CRP/PAB比值和MELD评分均对肝硬化脾切除患者术后PVT有一定的预测价值,且二者联合预测价值更高。Objective To investigate the predictive value of C-reactive protein/prealbumin(CRP/PAB)ratio combined with Model of end-stage liver disease(MELD)score for portal vein system thrombosis(PVT)after splenectomy.Methods A total of 63 patients with liver cirrhosis and splenectomy admitted to Nanchang Ninth Hospital from January 2020 to March 2022 were selected as the research objects.The related factors affecting postoperative PVT and the predictive value of CRP/PAB ratio combined with MELD score in predicting postoperative PVT were analyzed.Results There were statistically significant differences in the incidence of PVT in patients with liver cirrhosis undergoing splenectomy with different spleen weight,CRP/PAB ratio and MELD score(P<0.05).ROC curve showed that the AUC and cut-off value of CRP/PAB ratio in predicting postoperative PVT were 0.634 and 0.38,and the AUC and cut-off value of MELD score in predicting postoperative PVT were 0.852 and 14.62 point,respectively.The AUC of CRP/PAB ratio in predicting postoperative PVT was 0.880.Conclusion Spleen mass,CRP/PAB ratio and MELD score are related factors affecting PVT after splenectomy in patients with liver cirrhosis.Both CRP/PAB ratio and MELD score have certain predictive value for PVT after splenectomy in patients with liver cirrhosis,and their combined predictive value is higher.

关 键 词：C反应蛋白/前清蛋白比值 终末期肝病模型评分 肝硬化 脾切除围手术期 门静脉系统血栓 

分 类 号：R575[医药卫生—消化系统]