血清转氨酶联合Child-Pugh和ALBI评分预测心肺复苏自主循环恢复后缺氧性肝炎患者死亡的价值  

The Value of Serum Transaminase Combined with Child-Pugh and ALBI Score in Predicting the Death of Patients with Hypoxic Hepatitis after Cardiopulmonary Resuscitation and Recovery of Spontaneous Circulation

作　　者：杨阳 刘洋 刘纪宁 李梦滔 刘翠华 Yang Yang;Liu Yang;Liu Jining;Li Mengtao;Liu Cuihua(Emergency Department,Mianyang Hospital,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,Sichuan,China;不详)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院急诊科,四川省绵阳市621000

出　　处：《中国病案》2023年第1期92-95,共4页Chinese Medical Record

基　　金：四川省基层卫生事业发展研究中心项目(SWFZ19-Z-58);2020年度绵阳市中心医院院级课题(2020YJ04)。

摘　　要：目的 探讨血清转氨酶联合Child-Pugh评分、ALBI预测心肺复苏自主循环恢复后HH患者院内死亡的价值,为临床预后预测提供参考。方法 回顾性选择2018年10月1日-2021年10月1日某院收治的63例心肺复苏ROSC后HH患者(HH组)和509例心肺复苏ROSC后未发生HH的患者(对照组),根据心肺复苏ROSC后HH患者院内存活情况将患者分为死亡组(44例)和存活组(19例)。收集患者临床资料,检测血清谷丙转氨酶(ALT)、谷草转氨酶(AST),进行Child-Pugh和ALBI评分。采用受试者工作特征曲线(ROC)进行预测价值。结果 HH组ALT(203.53±34.09U/Lvs32.05±6.98U/L)、AST(80.25±23.09U/Lvs28.15±5.19U/L)、Child-Pugh评分(8.02±1.35分vs 2.01±0.33分)、ALBI评分(-1.32±0.41分vs-2.18±0.65分)均高于对照组(P<0.01)。死亡组ALT(212.35±16.94 U/L vs 183.84±10.94 U/L)、AST(86.35±19.02 U/L vs 66.12±5.37U/L)、Child-Pugh评分(8.51±0.62分vs6.89±0.21分)、ALBI评分(-1.20±0.18分vs-1.60±0.12分)均高于存活组(P<0.01)。ALT、AST、Child-Pugh、ALBI评分预测心肺复苏ROSC后HH患者院内死亡的曲线下面积为0.760、0.565、0.751、0.913,联合四项指标预测曲线下面积为0.990,高于单独指标预测(P<0.05)。结论 血清转氨酶联合Child-Pugh、ALBI评分对心肺复苏ROSC后HH患者院内死亡有较好的预测能力。Objectives This study aims to investigate the value of serum transaminase combined with Child-Pugh score and ALBI in predicting hospital death in patients with HH after cardiopulmonary resuscitation ROSC, and to provide a reference for clinical prognosis prediction.Methods This study retrospectively selected 63 patients with HH after cardiopulmonary resuscitation ROSC(HH group) and 509 patients without HH after cardiopulmonary resuscitation ROSC(control group) admitted to a hospital from October 1, 2018 to October 1, 2021. Patients were divided into the death group(44 cases) and the survival group(19 cases) according to the in-hospital survival of HH patients with ROSC after cardiopulmonary resuscitation. Clinical data of patients were collected and serum alanine aminotransferase(ALT), and aspartate aminotransferase(AST) were detected to perform Child-Pugh and ALBI scores. The receiver operating characteristic curve(ROC) was used to analyze the predictive value.Results ALT(203.53±34.09 U/L vs 32.05±6.98U/L), AST(80.25±23.09 U/L vs 28.15±5.19 U/L), Child-Pugh score(8.02±1.35 scores vs 2.01±0.33 scores)and ALBI score(-1.32±0.41 scores vs-2.18±0.65 scores) in HH group were higher than those of control group(P<0.01). ALT(212.35±16.94 U/L vs 183.84±10.94 U/L), AST(86.35±19.02 U/L vs 66.12±5.37 U/L),Child-Pugh score(8.51±0.62 score vs 6.89±0.21 score) and ALBI score(-1.20±0.18 score vs-1.60±0.12score) in death group were higher than those in survival group(P<0.01). The AUC of ALT, AST, Child-Pugh ad ALBI scores for predicting the nosocomial death of HH patients with ROSC after cardiopulmonary resuscitation were 0.760,0.565, 0.751, and 0.913. The AUC predicted by the four indexes combined was 0.990, which was higher than that of the individual indicators(P<0.05).Conclusions Serum transaminase combined with Child-Pugh and ALBI score has a good ability to predict nosocomial death in HH patients with ROSC after cardiopulmonary resuscitation.

关 键 词：转氨酶 CHILD-PUGH评分 白蛋白-胆红素评分 心肺复苏 缺氧性肝炎 

分 类 号：R575.1[医药卫生—消化系统]