中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2013年
2期
108-111
,共4页
陈剑尉%谭永法%周杰%阚和平%罗振超%陈立言
陳劍尉%譚永法%週傑%闞和平%囉振超%陳立言
진검위%담영법%주걸%감화평%라진초%진립언
终末期肝病模型%预测%生存率%肝移植%并发症
終末期肝病模型%預測%生存率%肝移植%併髮癥
종말기간병모형%예측%생존솔%간이식%병발증
Model for end-stage liver disease%Prediction%Survival rates%Liver transplantation%Complication
目的 探讨改进的终末期肝病模型(model for end-stage liver disease,MELD)对肝移植患者术后早期临床结果的预测价值.方法 回顾性分析218例肝移植患者的临床资料.利用受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under a curve,AUC)评价MELD、ReFit MELD及ReFit MELDNa评分预测患者肝移植术后3个月生存率的准确性.将各评分依各自临界值分成两组,分析各组早期并发症发生率与生存率结果.结果 MELD、ReFit MELD及ReFit MELDNa评分预测肝移植患者术后3个月的AUC分别为0.737(95％可信区间0.621～0.854)、0.727(95％可信区间0.663～0.785)及0.735(95％可信区间0.671～0.792),各评分间AUC无显著差异.各评分较高者术后3个月内肺部感染、腹腔感染和急性肾功能衰竭发生率及死亡率均显著升高.结论 术前ReFit MELD及ReFit MELDNa评分可作为肝移植患者术后早期生存的预测指标,但其预测能力与MELD评分无显著差异.三种评分高于各自临界值时并发症发生率较高,预后较差.
目的 探討改進的終末期肝病模型(model for end-stage liver disease,MELD)對肝移植患者術後早期臨床結果的預測價值.方法 迴顧性分析218例肝移植患者的臨床資料.利用受試者工作特徵(receiver operating characteristic,ROC)麯線下麵積(area under a curve,AUC)評價MELD、ReFit MELD及ReFit MELDNa評分預測患者肝移植術後3箇月生存率的準確性.將各評分依各自臨界值分成兩組,分析各組早期併髮癥髮生率與生存率結果.結果 MELD、ReFit MELD及ReFit MELDNa評分預測肝移植患者術後3箇月的AUC分彆為0.737(95％可信區間0.621～0.854)、0.727(95％可信區間0.663～0.785)及0.735(95％可信區間0.671～0.792),各評分間AUC無顯著差異.各評分較高者術後3箇月內肺部感染、腹腔感染和急性腎功能衰竭髮生率及死亡率均顯著升高.結論 術前ReFit MELD及ReFit MELDNa評分可作為肝移植患者術後早期生存的預測指標,但其預測能力與MELD評分無顯著差異.三種評分高于各自臨界值時併髮癥髮生率較高,預後較差.
목적 탐토개진적종말기간병모형(model for end-stage liver disease,MELD)대간이식환자술후조기림상결과적예측개치.방법 회고성분석218례간이식환자적림상자료.이용수시자공작특정(receiver operating characteristic,ROC)곡선하면적(area under a curve,AUC)평개MELD、ReFit MELD급ReFit MELDNa평분예측환자간이식술후3개월생존솔적준학성.장각평분의각자림계치분성량조,분석각조조기병발증발생솔여생존솔결과.결과 MELD、ReFit MELD급ReFit MELDNa평분예측간이식환자술후3개월적AUC분별위0.737(95％가신구간0.621～0.854)、0.727(95％가신구간0.663～0.785)급0.735(95％가신구간0.671～0.792),각평분간AUC무현저차이.각평분교고자술후3개월내폐부감염、복강감염화급성신공능쇠갈발생솔급사망솔균현저승고.결론 술전ReFit MELD급ReFit MELDNa평분가작위간이식환자술후조기생존적예측지표,단기예측능력여MELD평분무현저차이.삼충평분고우각자림계치시병발증발생솔교고,예후교차.
Objectives To evaluate the predictive value of the revised model for end-stage liver disease in the clinical early stage after liver transplantation.Methods The clinical data of 218 patients were retrospectively analyzed.After calculating the MELD score,ReFit MELD score and ReFit MELDNa score before transplantation,we compared the predictive accuracies of these scoring systems using the area under curve (AUC) of the receiver operating characteristic.The groups were categorized with the cut-offs of the MELD,ReFit MELD and ReFit MELDNa,and the early-stage complications and mortality in the different groups were analyzed.Results The AUC for the MELD,ReFit MELD and ReFit MELDNa were 0.737 (95％CI 0.621～0.854),0.727 (95％CI 0.663～0.785) and 0.735 (95％CI 0.671～0.792),respectively.There was no statistical difference is the AUC among the MELD,ReFit MELD and ReFit MELDNa.Elevated scores in the 3 models predicted higher rates of pulmonary infection,abdominal infection and acute renal dysfunction,as well as a higher mortality.Conclusions The ReFit MELD score and ReFit MELDNa score were relatively useful predictors of short-term survival rates after liver transplantation.The predictive accuracy was similar to the MELD score.Values of the score above the cutoff values indicated higher rates of complication and poorer prognosis.
