摘要
目的探讨终末期肝病模型(MELD)评分联合血清凝血酶原时间(PT)、血清乳酸/肌酐比值评估肝功能衰竭患者人工肝预后的价值。方法抽取2017年5月至2019年5月信阳市中心医院收治的181例肝功能衰竭患者,均接受人工肝治疗;根据住院3个月内预后情况分为预后良好组(121例)和预后较差组(60例);比较两组患者MELD评分、PT、血清乳酸/肌酐比值;分析患者肝功能衰竭分期与MELD评分、PT、血清乳酸/肌酐比的相关性;分析MELD评分联合血清PT、血清乳酸/肌酐比值评估肝功能衰竭患者人工肝的预后价值。结果与预后良好组比较,预后较差组MELD评分、血清PT、血清乳酸/肌酐比值更高(P<0.05);与早期和中期肝功能衰竭患者比较,晚期患者MELD评分、血清PT、血清乳酸/肌酐比值更高;与早期肝功能衰竭患者比较,中期肝功能衰竭患者MELD评分、血清PT、血清乳酸/肌酐比值较高(P<0.05)。经相关性分析发现,MELD评分、血清PT、血清乳酸/肌酐比值与肝功能衰竭的恶性程度呈正相关;经分析发现,MELD评分联合血清PT、血清乳酸/肌酐检测的灵敏度与特异性均高于各项单独检测。结论MELD评分、血清PT、血清乳酸/肌酐比值与患者肝功能衰竭的病情程度呈正相关。MELD评分联合血清PT、血清乳酸/肌酐比值能够准确评估肝功能衰竭患者人工肝的预后。
Objective To study the value of model for end-stage liver disease(MELD)score combined with serum prothrombin time(PT)and serum lactic acid/creatinine ratio in evaluating the prognosis of artificial liver in patients with liver failure.Methods One hundred and eighty-one patients with liver failure admitted to Xinyang Central Hospital from May 2017 to May 2019 were enrolled and received artificial liver treatment.According to the prognosis within 3 months of hospitalization,they were divided into good prognosis group(n=121)and poor prognosis group(n=60).MELD score,serum PT,and serum lactic acid/creatinine ratio were compared between the two groups.Correlation analysis was performed between liver failure stages with MELD score,PT,and serum lactate/creatinine ratio.The prognostic value of MELD score combined with serum PT and serum lactate/creatinine ratio to evaluate the artificial liver in patients with liver failure was analyzed.Results Compared with the good prognosis group,MELD score,serum PT,and serum lactic acid/creatinine ratio of the poor prognosis group were significantly higher(P<0.05).Compared with patients with early and mid-stage liver failure,the MELD score,the serum PT and the serum lactic acid/creatinine ratio in the advanced patients were significantly higher.Compared with patients with early liver failure,MELD score,serum PT and serum lactic acid/creatinine ratio were significantly higher in patients with intermediate liver failure(P<0.05).According to correlation analysis,MELD score,serum PT,serum lactic acid/creatinine ratio were positively correlated with the malignancy of liver failure.Analysis showed that the detection sensitivity and the specificity of MELD score combined with serum PT,serum lactic acid/creatinine are higher than the single one.Conclusions MELD score,serum PT,and serum lactic acid/creatinine ratio are positively correlated with the degree of liver failure;their combination can accurately assess the prognosis of artificial liver in liver failure patients.
作者
陈莉莉
李梦蝶
Chen Lili;Li Mengdie(Department of Gastroenterology,Xinyang Central Hospital,Xinyang 464000,China;Department of Critical Care Medicine,Xinyang Central Hospital,Xinyang 464000,China)
出处
《中国实用医刊》
2021年第6期50-53,共4页
Chinese Journal of Practical Medicine
