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目的探讨血清铁蛋白对肝硬化失代偿患者早期死亡的预测价值。方法根据研究对象血清铁蛋白(SF)水平高低分为低、中、高3组,比较肝硬化相关指标的基线水平。根据随访15 d和30 d内是否存活分生存组和死亡组,比较2组SF指标、终末期肝病的危险度评分模型(MELD)积分、Child-Turcotte-Pugh(CTP)积分,并比较SF、MELD积分、CTP积分的相关性及ROC曲线下面积。结果 SF高、中、低水平组相关指标组间比较差异具有统计学意义(P<0.05)。随访15 d内和30 d内,生存组与死亡组的SF、MELD、CTP积分组间比较差异具有统计学意义(P<0.05);SF与MELD、CTP呈正相关。随访30 d内,MELD、SF指标和CTP的AUC(95%CI)分别为0.867(0.806~0.928)、0.800(0.723~0.877)、0.786(0.706~0.865),表明MELD法优于SF诊断,SF优于CTP,且差异有统计学意义(P<0.05)。结论 SF与肝硬化失代偿期患者病变程度和短期预后相关,可预测肝硬化失代偿期患者的早期死亡率。
Objective To investigate the predictive value of serum ferritin in the early death of patients with decompensated cirrhosis. Methods According to the level of serum ferritin (SF), the subjects were divided into low, medium and high groups. The baseline levels of liver cirrhosis-related indicators were compared. According to whether survival survivors and death groups were observed on the 15th and 30th follow-up, MELD scores and Child-Turcotte-Pugh (CTP) scores were compared between the two groups in terms of SF, SF, MELD score, CTP score, and area under the ROC curve. Results There were significant differences between the groups of related indicators of high, medium and low SF group (P <0.05). The SF, MELD and CTP scores between the survival group and the death group were statistically significant at 15 and 30 days of follow-up (P <0.05). There was a positive correlation between SF and MELD and CTP. The AUC (95% CI) of MELD, SF and CTP were 0.867 (0.806-0.928), 0.800 (0.723-0.877) and 0.786 (0.706-0.865) respectively within 30 days of follow-up, indicating that MELD was superior to SF diagnosis and SF Better than CTP, and the difference was statistically significant (P <0.05). Conclusions SF is associated with the degree of disease and short-term prognosis in patients with decompensated liver cirrhosis and predicts early mortality in patients with decompensated cirrhosis.