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目的研究影响慢性乙型重型肝炎患者短期预后的危险因素,建立预后模型,并比较其与MELD评分对此类患者短期预后的评估价值。方法回顾性分析152例慢性乙型重型肝炎病例,进行单因素及Logistic回归分析。绘制新建预测模型和MELD评分系统的ROC曲线,并比较曲线下面积(AUC)。结果单因素分析后有统计学意义的指标是年龄、肝硬化、TBil、ALB、CHE、Cr、WBC、INR、BUN、PT、ICGR15。回归模型:P=1/(1+e-y),Y=0.085×年龄+2.214×肝硬化+0.015×TBil+1.763×INR-16.613,与MELD评分比较差异有统计学意义。结论年龄、肝硬化、TBil、INR是判断慢性乙型重型肝炎患者短期预后的独立危险因素。新建预测模型的预测价值优于MELD评分系统。
Objective To study the risk factors affecting the short-term prognosis of patients with chronic severe hepatitis B and to establish a prognostic model, and to evaluate its short-term prognosis with MELD score. Methods A retrospective analysis of 152 cases of chronic severe hepatitis B, single factor and Logistic regression analysis. The ROC curve of the new predictive model and the MELD scoring system was plotted and the area under the curve (AUC) was compared. Results The statistically significant indicators after univariate analysis were age, cirrhosis, TBil, ALB, CHE, Cr, WBC, INR, BUN, PT and ICGR15. The regression model was significantly different from the MELD score, P = 1 / (1 + e-y), Y = 0.085 × age + 2.214 × cirrhosis + 0.015 × TBil + 1.763 × INR-16.613. Conclusion Age, cirrhosis, TBil and INR are independent risk factors for short-term prognosis of patients with chronic severe hepatitis B. The predictive value of the new prediction model is better than the MELD scoring system.