中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2013年
6期
321-324
,共4页
刘添皇%朱建芸%张绍全%谢仕斌%柯伟民%高志良
劉添皇%硃建蕓%張紹全%謝仕斌%柯偉民%高誌良
류첨황%주건예%장소전%사사빈%가위민%고지량
肝炎,乙型%肝功能衰竭,急性%严重度评分%终末期肝病模型
肝炎,乙型%肝功能衰竭,急性%嚴重度評分%終末期肝病模型
간염,을형%간공능쇠갈,급성%엄중도평분%종말기간병모형
Hepatitis B%Liver failure,acute%Severity score%Model for end-stage liver disease
目的 对一种针对慢加急性乙型肝炎肝衰竭严重性评估的新评分系统的临床应用价值进行解读.方法 收集2003年1月至2008年6月中山大学附属第三医院感染科399例慢加急性乙型肝炎肝衰竭住院患者,其中存活203例,死亡196例.对所有患者同时用新评分系统和终末期肝病模型(MELD)进行评分(存活组于疾病极期评分,死亡组于临终前评分).绘制两个评分系统的存活率和病死率分布图,并以此对两个评分系统的临床应用价值进行解读.结果 采用MELD进行评分,评分在15～ 26分的143例患者病死率为11.89％ (17/143),评分在27～48分的218例患者病死率为64.68％ (141/218),评分在49 ～ 69分的38例患者病死率为100％ (38/38),不存在100％存活的分数段.采用新评分系统进行评分,评分在2～8分的127例患者生存率为99.2％ (126/127),其中,2,3,4,5,6和8六个评分的生存率为100％;评分在9～17分的患者病死率自4.2％ (1/24)逐渐上升,18分及以上患者的病死率为100％ (82/82).结论 新评分系统的敏感性优于MELD系统,评价指标客观,计算简单,可用于慢加急性乙型肝炎肝衰竭的严重程度评估.
目的 對一種針對慢加急性乙型肝炎肝衰竭嚴重性評估的新評分繫統的臨床應用價值進行解讀.方法 收集2003年1月至2008年6月中山大學附屬第三醫院感染科399例慢加急性乙型肝炎肝衰竭住院患者,其中存活203例,死亡196例.對所有患者同時用新評分繫統和終末期肝病模型(MELD)進行評分(存活組于疾病極期評分,死亡組于臨終前評分).繪製兩箇評分繫統的存活率和病死率分佈圖,併以此對兩箇評分繫統的臨床應用價值進行解讀.結果 採用MELD進行評分,評分在15～ 26分的143例患者病死率為11.89％ (17/143),評分在27～48分的218例患者病死率為64.68％ (141/218),評分在49 ～ 69分的38例患者病死率為100％ (38/38),不存在100％存活的分數段.採用新評分繫統進行評分,評分在2～8分的127例患者生存率為99.2％ (126/127),其中,2,3,4,5,6和8六箇評分的生存率為100％;評分在9～17分的患者病死率自4.2％ (1/24)逐漸上升,18分及以上患者的病死率為100％ (82/82).結論 新評分繫統的敏感性優于MELD繫統,評價指標客觀,計算簡單,可用于慢加急性乙型肝炎肝衰竭的嚴重程度評估.
목적 대일충침대만가급성을형간염간쇠갈엄중성평고적신평분계통적림상응용개치진행해독.방법 수집2003년1월지2008년6월중산대학부속제삼의원감염과399례만가급성을형간염간쇠갈주원환자,기중존활203례,사망196례.대소유환자동시용신평분계통화종말기간병모형(MELD)진행평분(존활조우질병겁기평분,사망조우림종전평분).회제량개평분계통적존활솔화병사솔분포도,병이차대량개평분계통적림상응용개치진행해독.결과 채용MELD진행평분,평분재15～ 26분적143례환자병사솔위11.89％ (17/143),평분재27～48분적218례환자병사솔위64.68％ (141/218),평분재49 ～ 69분적38례환자병사솔위100％ (38/38),불존재100％존활적분수단.채용신평분계통진행평분,평분재2～8분적127례환자생존솔위99.2％ (126/127),기중,2,3,4,5,6화8륙개평분적생존솔위100％;평분재9～17분적환자병사솔자4.2％ (1/24)축점상승,18분급이상환자적병사솔위100％ (82/82).결론 신평분계통적민감성우우MELD계통,평개지표객관,계산간단,가용우만가급성을형간염간쇠갈적엄중정도평고.
Objective To assess the application of a new scoring system for severity evaluation of acute-on-chronic liver failure induced by hepatitis B.Methods A total of 399 patients (203 survivals and 196 deaths) with acute-on-chronic liver failure induced by hepatitis B were collected from the Third Affiliated Hospital of Sun Yat-sen University during January 2003 and June 2008.All patients were graded with the new scoring system and model for end-stage liver disease (MELD) at critical stage (survivals) or terminal stage (deaths).The survival rates and fatality rates of patients who were graded by two scoring systems were analyzed and compared.Results With MELD system,the fatality rate was 11.89％ (17/143) in patients with scores of 15-26,64.68％ (141/218) with scores of 27-48,and 100％ (38/38) with scores of 49-69.No score range with fatality rate of 0 was found.While with the new scoring system,the survival rate was 99.2％ (126/127) when the severity scores were between 2 to 8,and patients with scores 2,3,4,5,6 and 8 were all survived; the fatality rates were gradually raised from 4.2％ (1/24) with scores of 9-17 to 100％ (82/82) with scores of 18 and above.Conclusion The new scoring system is more objective,simple and sensitive than MELD system,which can be used for severity evaluation of acute-onchronic liver failure induced by hepatitis B.
