河南医学研究
河南醫學研究
하남의학연구
HENAN MEDICAL RESEARCH
2014年
12期
13-16
,共4页
宋晨源%吴武佳%吕元君%郭智贤%余祖江
宋晨源%吳武佳%呂元君%郭智賢%餘祖江
송신원%오무가%려원군%곽지현%여조강
乙肝%肝衰竭%降钙素原%Child-Pugh评分%预后
乙肝%肝衰竭%降鈣素原%Child-Pugh評分%預後
을간%간쇠갈%강개소원%Child-Pugh평분%예후
hepatitis B%liver failure%PCT%Child-Pugh score%prognosis
目的：：探讨降钙素原( PCT)与Child-Pugh评分对乙肝相关慢加急性肝衰竭预后评估的价值。方法：对113例乙肝相关慢加急性肝衰竭患者的生存率进行回顾性分析,根据患者入院当天的检查指标计算Child-Pugh评分并统计降钙素原数值,以受试者工作曲线( ROC)下的面积来评价两者预测预后的能力,同时进行二者的相关性分析。结果：Child-Pugh评分与降钙素原呈显著相关(r=0.64,P<0.01)。113例患者中死亡29例,死亡组Child-Pugh评分及降钙素原值均高于生存组(P<0.01)；根据ROC曲线Child-Pugh评分截断值为11.00,敏感度69%,特异性73%；降钙素原截断值为2.66,敏感度为58%,特异性为67%；二者联合应用则敏感度及特异性可分别提高至89%和77%。结论：Child-Pugh评分及降钙素原对乙肝相关慢加急性肝衰竭的预后均可做出有效的预测,二者联用可以提高预测准确度。
目的：：探討降鈣素原( PCT)與Child-Pugh評分對乙肝相關慢加急性肝衰竭預後評估的價值。方法：對113例乙肝相關慢加急性肝衰竭患者的生存率進行迴顧性分析,根據患者入院噹天的檢查指標計算Child-Pugh評分併統計降鈣素原數值,以受試者工作麯線( ROC)下的麵積來評價兩者預測預後的能力,同時進行二者的相關性分析。結果：Child-Pugh評分與降鈣素原呈顯著相關(r=0.64,P<0.01)。113例患者中死亡29例,死亡組Child-Pugh評分及降鈣素原值均高于生存組(P<0.01)；根據ROC麯線Child-Pugh評分截斷值為11.00,敏感度69%,特異性73%；降鈣素原截斷值為2.66,敏感度為58%,特異性為67%；二者聯閤應用則敏感度及特異性可分彆提高至89%和77%。結論：Child-Pugh評分及降鈣素原對乙肝相關慢加急性肝衰竭的預後均可做齣有效的預測,二者聯用可以提高預測準確度。
목적：：탐토강개소원( PCT)여Child-Pugh평분대을간상관만가급성간쇠갈예후평고적개치。방법：대113례을간상관만가급성간쇠갈환자적생존솔진행회고성분석,근거환자입원당천적검사지표계산Child-Pugh평분병통계강개소원수치,이수시자공작곡선( ROC)하적면적래평개량자예측예후적능력,동시진행이자적상관성분석。결과：Child-Pugh평분여강개소원정현저상관(r=0.64,P<0.01)。113례환자중사망29례,사망조Child-Pugh평분급강개소원치균고우생존조(P<0.01)；근거ROC곡선Child-Pugh평분절단치위11.00,민감도69%,특이성73%；강개소원절단치위2.66,민감도위58%,특이성위67%；이자연합응용칙민감도급특이성가분별제고지89%화77%。결론：Child-Pugh평분급강개소원대을간상관만가급성간쇠갈적예후균가주출유효적예측,이자련용가이제고예측준학도。
Objective:To assess the prognostic value of PCT and the Child-Pugh score in patients with HBV-related acute-on-chronic liver failure,and to evaluate the relationship between PCT and the Child-Pugh score. Methods: The value of PCT and Child-Pugh score of 113 patients with HBV-related acute-on-chronic liver failure were retrospectively calculated. Using Receiver operat-ing characteristic curves to determine PCT and the Child-Pugh score cut-offs with the best sensitivi-ty ( SS) and specificity ( SP) in discriminating between patients who survived and those who died. Results:PCT and Child-Pugh score showed significant correlation ( r=0 . 64 , P<0 . 01 ) . Among the 113 patients PCT and Child-Pugh score of the 29 patients who died were significantly higher than those who survived. According to the ROC curves a Child-Pugh score cut-off of 11. 00 had 69% SS and 73% SP, whereas a PCT cut-off of 2. 66 had 58% SS and 67% SP in discriminating between patients who survived and those who died. The combined assessment of PCT and Child-Pugh score had 89% SS and 77% SP. Conclusion:In patients with HBV-related acute-on-chronic liver failure, the PCT has prognostic capability that is not significantly different from that of Child-Pugh score. Combined assessment of the two parameters increases the prognostic accuracy.
