摘要
【目的】探讨终末期肝病模型(MELD)评分系统对预测慢性重型乙型病毒性肝炎患者短期预后的临床应用价值。【方法】164例慢性重型乙型病毒性肝炎患者临床资料按有无肝硬化进行分组,进行MELD评分,观察MELD分值的变化并比较慢性重型乙型病毒性肝炎患者的短期预后差异。【结果】①所观察病例的MELD评分均在20分以上(包括20分);其中肝硬化组(46例)的MELD值为31.89±1.07,慢性肝炎组(118例)为34.03±0.81,肝硬化组与慢性肝炎组间MELD分值比较,P>0.05,无统计学差异,患者起病时有无肝硬化的基础,可能对慢性重型乙型病毒性肝炎患者的短期预后影响不大。②慢性重型乙型病毒性肝炎患者3个月内的病死率在20≤MELD<30为42.4%(28/66),30≤MELD<40为73.2%(52/71),MELD≥40为96.2%(26/27),MELD分值越高,病死率越高。【结论】MELD评分系统是一种适用于我国而且比较可靠的预测慢性重型乙型病毒性肝炎患者短期预后的方法。
[ Objective ] To assess the value of the model for end-stage liver disease （MELD） on the short-term prognosis in the patients with chronic liver failure （chronic and severe hepatitis B）. [Methods] The clinical information of 164 patients with chronic liver failure was collected. The patients were divided into two groups, including cirrhosis group and non-cirrhosis group （chronic hepatitis group）. All the patients were valued by MELD. The relationship was analyzed between the value of MELD and the prognosis of the patients. [Results] （1） The values of MELD in all patients were no less than 20. They were 31.89±1.07 in cirrhosis group （n=46） and 34.03± 0.81 in chronic hepatitis group （n=118）respectively. The value of MELD in cirrhosis group had no significant difference from that in chronic hepatitis group （P 〉0.05）. The patients＇ onset of chronic liver failure based on cirrhosis might have no important effect on the short-term prognosis. （2） The death rates were 42.4% （28/66）, 73.2%（52/71）, and 96.2%（26/27） in the patients with 20 ≤MELD〈30, 30 ≤MELD〈40, and MELD ≥40, respectively. The higher the MELD value, the higher the death rate. [Conclusions] MEDL system was an effective method to predict the short-term prognosis in the patients with chronic liver failure.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2006年第5期594-596,共3页
Journal of Sun Yat-Sen University:Medical Sciences
作者简介
陈瑞玲（1972-），女，广西桂林人，主治医师，广西桂林南溪山医院肝病科；
崇雨田，副教授，通讯作者。E-mail：ytchong2005@126.com.
