摘要
[目的] 探讨天冬氨酸转氨酶(AST)/丙氨酸氨基转移酶(ALT)比值与 Child Pugh评分对慢性乙肝肝硬化患者短、中期预后评估的价值。[方法] 对173例肝硬化患者的生存率进行回顾性评估,随访1 a。计算每例患者入院当天的AST/ALT比值与Child Pugh评分,以受试者特征曲线(ROC)下的面积衡量两者预测患者预后的能力,分析AST/ALT比值与Child Pugh评分的相关性。[结果] AST/ALT比值与 Child Pugh 评分呈显著相关( r=0 53,P<0 01)。随访3个月及1 a内分别有30例及50例患者死亡,死亡者AST/ALT比值与 Child Pugh 评分显著高于生存者(P<0 01)。依据 ROC曲线 AST/ALT比值截断值为 1 6,对患者 1 a预后判断的敏感性为55%,特异性为72%;Child Pugh 评分截断值为10,其敏感性76%,特异性 68%,联合应用两者敏感性和特异性可分别提高至85% 和76%。[结论] AST/ALT比值及Child Pugh评分均可有效地预测肝硬化患者的短期和中期预后,联合应用可提高其准确率。
Objective] To assess the prognostic ability of the AST/ALT ratio in patients with hepatitis B liver cirrhosis, and to evaluate the relationship between the AST/ALT ratio and the Child Pugh score and to compare their prognostic ability. [Methods] The AST/ALT ratio and Child Pugh score of 173 patients with hepatitis B liver cirrhosis who had been followed up for at least 1 year were retrospectively calculated and correlated with the patients' 3 month and 1 year prognosis. Receiver operating characteristic curves were used to determine the AST/ALT ratio and the Child Pugh score cut offs with the best sensitivity (SS) and specificity (SP) in discriminating between patients who survived and those who died. [Results] AST/ALT ratios and Child Pugh score showed significant correlation (r = 0 53, P<0 01). In all, 17% (30/173) and 28% (50/173) of the patients had died after 3 months and 1 year of follow up, respectively. AST/ALT ratio and Child Pugh score were significantly higher among the patients who died during both 3 month and 1 yr follow up. An AST/ALT ratio cut off of 1.6 had 55% SS and 72% SP, whereas a Child Pugh score cut off of 10 had 76% SS and 68% SP in discriminating between patients who survived and those who died after 1 year. The combined assessment of the AST/ALT ratio and Child Pugh score had 85% SS and 76% SP. [Conclusion] In patients with hepatitis B liver cirrhosis, the AST/ALT ratio has prognostic capability that is not significantly different from that of Child Pugh score. Combined assessment of the two parameters increases the medium term prognostic accuracy.
出处
《中国中西医结合消化杂志》
CAS
2005年第1期28-30,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
