CAJ | 학술논문

目的筛选超声早期预测重型肝炎预后的相关指标,并探讨其临床价值.方法回顾性分析2010年7月至2013年7月在我院诊治的269例重型肝炎患者资料,采用Cox比例风险回归模型对右肝厚度、门静脉管径等13个指标进行多因素分析,筛选预测指标,并用ROC曲线评价其临床价值.结果多因素分析显示右肝厚度、门静脉管径、附脐静脉开放及胆汁黏稠与重型肝炎患者死亡有关(P＜0.05),其中右肝厚度对预测重型肝炎患者死亡的贡献率最高(Wald=40.479),其预测死亡的敏感性、特异性分别为93.4％、82.8％,(P＜0.01).结论右肝厚度、门静脉管径、附脐静脉开放以及胆汁黏稠是超声早期预测重型肝炎预后的有效指标,在治疗过程中应予以重视并密切观察.
목적 사선초성조기예측중형간염예후적상관지표,병탐토기림상개치.방법 회고성분석2010년7월지2013년7월재아원진치적269례중형간염환자자료,채용Cox비례풍험회귀모형대우간후도、문정맥관경등13개지표진행다인소분석,사선예측지표,병용ROC곡선평개기림상개치.결과 다인소분석현시우간후도、문정맥관경、부제정맥개방급담즙점주여중형간염환자사망유관(P＜0.05),기중우간후도대예측중형간염환자사망적공헌솔최고(Wald=40.479),기예측사망적민감성、특이성분별위93.4％、82.8％,(P＜0.01).결론 우간후도、문정맥관경、부제정맥개방이급담즙점주시초성조기예측중형간염예후적유효지표,재치료과정중응여이중시병밀절관찰.
Objective To select early prediction indexes related to the prognosis of severe hepatitis in ultrasonography,and evaluate its clinical value.Methods Clinical data of 269 cases of severe hepatitis patients was analyzed retrospectively.Cox proportional hazards regression model was adopted to analyze 13 possible prediction ultrasonic parameters for severe hepatitis,including thickness of the right hepatic lobe,portal vein (PV) diameter,volume of ascites,etc.After selected from these parameters,the clinical value of early prediction factor was evaluated with ROC curve.Results Multivariate analysis showed that thickness of the right hepatic lobe,portal vein (PV) diameter,opening of paraumbilical vein and bile viscosity were related to the death of severe hepatitis patients (P ＜ 0.05).The thickness of the right hepatic lobe contributed most (Wald =40.479),its sensitivity and specificity for prediction were 93.4％,82.8％ respectively(P ＜ 0.01).Conclusions Thickness of the right hepatic lobe,PV diameter,opening paraumbilical vein and bile viscosity are early prediction factors for severe hepatitis,need to be monitored in treatment,especially for thickness of the right hepatic lobe.