中山大学学报（医学科学版）2011，Vol.32Issue(6)：834-840,7.
慢加急性肝衰竭预后评分系统的建立与评估
Establishment and Evaluation of Prognosis Scoring System for Acute-on-Chronic Liver Failure
摘要
Abstract
[Objective]To establish a simple and practical system to predict the prognosis of acute-on-chronic liver failure (ACLF). [Methods] All 558 patients with acute-on-chronic hepatitis B liver failure were divided into death group and survival group according to the clinical outcome. And all the patients were also divided into training samples (n = 499) and testing samples (n = 59) with a ratio of 9:1. Univariate analysis was used to screen the most influential independent risk factors. Each factor was given a certain score.A prognosis scoring system was established based on these factors with the method of discriminant analysis. A Fisher's discriminant formula and discriminant value were obtained. The efficacy of discriminant formula was checked with retrospective validation and cross-validation in training sample and prospective validation in testing sample. [Results] Univariate analysis showed statically significant index including age, the pre-existing cirrhosis, aspartic transaminase levels, et al. Finally, six factors (level of serum total bilirubine, prothrombin time, severity of hepatic encephalopathy, hepatorenal syndrome, ascites and infection) which were easier to evaluate and more influential, were included to establish a prognosis scoring system. Using this scoring system, the patients with a score of 6, 7, 8, 9, 10, and 3=11 showed a mortality of 34.9%, 66.7%, 76.7%, 85.7%, 91.7%, and 100%,respectively. The efficacy of prediction of discriminant formula was 75.1%-88.9% in training samples and 74.3%-88.0% in testing samples. [Conclusions] In dynamic assessment, the prognosis scoring system we established here was simple, practical and efficient when predicting the prognosis of patients with ACLF.关键词
慢加急性肝衰竭/评分系统/预后评估Key words
acute-on-chronic liver failure/ scoring system/ prognosis evaluation分类
医药卫生引用本文复制引用
谢仕斌,吴元凯,朱建芸,张英,陈淑如,凌莉,柯伟民,高志良..慢加急性肝衰竭预后评分系统的建立与评估[J].中山大学学报（医学科学版）,2011,32(6):834-840,7.基金项目
广东省科技计划项目(2009B030801006) （2009B030801006）
