中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
9期
933-936
,共4页
肝硬化%胆固醇%内毒素%终末期肝病血清钠模型
肝硬化%膽固醇%內毒素%終末期肝病血清鈉模型
간경화%담고순%내독소%종말기간병혈청납모형
Liver cirrhosis%Cholesterol%Endotoxin%MELD-Na
目的 探讨终末期肝病血清钠(MELD-Na)评分联合血清内毒素、胆固醇对肝硬化失代偿期患者预后的判断价值.方法 回顾性分析失代偿期肝硬化住院患者156例的临床资料,分别根据随访6、12、24个月的生存、死亡情况分组,通过测定相关指标计算存活组与死亡组患者MELD-Na分值,测定血清内毒素、胆固醇浓度,分析MELD-Na分值联合血清内毒素、胆固醇浓度与肝硬化失代偿期患者预后相关性.结果 随访6个月,19例死亡；随访12个月,59例死亡；随访24个月,77例死亡.6、12、24个月存活组与死亡组患者MELD-Na分值、血清内毒素、血清胆固醇浓度之间的差异均有统计学意义(t值分别为-9.68、-9.22、11.40,-4.65、-19.60、16.20,-20.0、-18.7、17.3,P均＜0.05).MELD-Na分值预测失代偿期肝硬化患者死亡的最佳临界值为32分,MELD-Na分值增高患者死亡风险也增加；血清内毒素预测患者死亡的最佳临界值为≥12 ng/L,血清胆固醇预测患者死亡的最佳临界值为≤1.70mmol/L,血清胆固醇降低、内毒素浓度增高可增加患者死亡风险.结论 MELD-Na评分联合血清内毒素、胆固醇浓度对肝硬化失代偿期患者预后有较高的判断价值.
目的 探討終末期肝病血清鈉(MELD-Na)評分聯閤血清內毒素、膽固醇對肝硬化失代償期患者預後的判斷價值.方法 迴顧性分析失代償期肝硬化住院患者156例的臨床資料,分彆根據隨訪6、12、24箇月的生存、死亡情況分組,通過測定相關指標計算存活組與死亡組患者MELD-Na分值,測定血清內毒素、膽固醇濃度,分析MELD-Na分值聯閤血清內毒素、膽固醇濃度與肝硬化失代償期患者預後相關性.結果 隨訪6箇月,19例死亡；隨訪12箇月,59例死亡；隨訪24箇月,77例死亡.6、12、24箇月存活組與死亡組患者MELD-Na分值、血清內毒素、血清膽固醇濃度之間的差異均有統計學意義(t值分彆為-9.68、-9.22、11.40,-4.65、-19.60、16.20,-20.0、-18.7、17.3,P均＜0.05).MELD-Na分值預測失代償期肝硬化患者死亡的最佳臨界值為32分,MELD-Na分值增高患者死亡風險也增加；血清內毒素預測患者死亡的最佳臨界值為≥12 ng/L,血清膽固醇預測患者死亡的最佳臨界值為≤1.70mmol/L,血清膽固醇降低、內毒素濃度增高可增加患者死亡風險.結論 MELD-Na評分聯閤血清內毒素、膽固醇濃度對肝硬化失代償期患者預後有較高的判斷價值.
목적 탐토종말기간병혈청납(MELD-Na)평분연합혈청내독소、담고순대간경화실대상기환자예후적판단개치.방법 회고성분석실대상기간경화주원환자156례적림상자료,분별근거수방6、12、24개월적생존、사망정황분조,통과측정상관지표계산존활조여사망조환자MELD-Na분치,측정혈청내독소、담고순농도,분석MELD-Na분치연합혈청내독소、담고순농도여간경화실대상기환자예후상관성.결과 수방6개월,19례사망；수방12개월,59례사망；수방24개월,77례사망.6、12、24개월존활조여사망조환자MELD-Na분치、혈청내독소、혈청담고순농도지간적차이균유통계학의의(t치분별위-9.68、-9.22、11.40,-4.65、-19.60、16.20,-20.0、-18.7、17.3,P균＜0.05).MELD-Na분치예측실대상기간경화환자사망적최가림계치위32분,MELD-Na분치증고환자사망풍험야증가；혈청내독소예측환자사망적최가림계치위≥12 ng/L,혈청담고순예측환자사망적최가림계치위≤1.70mmol/L,혈청담고순강저、내독소농도증고가증가환자사망풍험.결론 MELD-Na평분연합혈청내독소、담고순농도대간경화실대상기환자예후유교고적판단개치.
Objective To evaluate the prognosis of the decompensated liver cirrhosis by means of MELD-Na score combined with serum cholesterol and endotoxin concentration.Methods Data of 156 hospitalized patients with decompensated liver cirrhosis was retrospectively analyzed.Patients were divided into survival and death group according to follow-ups at 6 months,12 months and 24 months.MELD-Na score was made among 156 patients by detecting relevant indicators.Serum cholesterol and cholesterol levels were measured,too.The relationship between decompensated liver cirrhosis prognosis and MELD-Na score combined with serum cholesterol and endotoxin concentration was analyzed.Results Ninteen patients died at the follow-up for 6 months.Fifty nine patients died at the followe-up for 12 months.Seventy seven patients died at the follow-up for 24 months.There was significant difference on MELD-Na score,endotoxin concentration and serum cholesterol between the survival group and the death group (t =-9.68,-9.22,11.4,-4.65,-19.60,16.20,-20.0,-18.7,17.3,respectively,P ＜0.05).The best critical value of MELD-Na score to predicate death in patients with decompensated liver cirrhosis was 32 points.The risk of death would rise if MELD-Na score increased.The best critical value of plasma endotoxin to predicate death in patients with decompensated liver cirrhosis was ≥ 12 ng/L.The best threshold value of serum cholesterol to predict death in patients with decompensated liver cirrhosis was ≤ 1.70 mmol/L.Conclusion MELD-Na score,serum cholesterol and serum endotoxin were of higher prognostic value to judge the prognosis of patients with decompensated liver cirrhosis.
