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目的评估终末期肝病血清钠(MELD-Na)、终末期肝病模型(MELD)及Child-Pugh评分系统对失代偿期肝硬化患者短期预后的预测价值。方法对具有完整记录和随访结果的96例失代偿期肝硬化患者的资料进行分析,分别计算每例患者的Chlid-Pugh、MELD及MELD-Na分值,使用受试者工作曲线(ROC)及曲线下面积(AUC)比较3种评分系统判断失代偿期肝硬化患者生存3个月的准确性。结果 96例患者3个月内有25例患者死亡。死亡组的Child-Pugh、MELD及MELD-Na评分均高于生存组(P<0.01);MELD-Na和MELD评分在判断患者3个月生存时间的ROC曲线AUC均大于Child-Pugh(P<0.001,P<0.01),MELD-Na和MELD评分AUC差异均无统计学意义(P>0.05)。结论 MELD-Na是判断失代偿期肝硬化患者短期预后的一个较好指标,其准确性优于Child-Pugh分级,但与MELD评分相比无明显差异。
Objective To evaluate the predictive value of MELD-Na, MELD and Child-Pugh scores in short-term prognosis of patients with decompensated cirrhosis. Methods The data of 96 patients with decompensated cirrhosis with complete records and follow-up results were analyzed. Chlid-Pugh, MELD and MELD-Na scores were calculated for each patient. The receiver operating characteristic curve (ROC) And area under the curve (AUC) were compared to determine the accuracy of 3-month survival in patients with decompensated cirrhosis. Results 96 patients died within 3 months in 25 patients. The AUC of Child-Pugh, MELD and MELD-Na in the death group were higher than those in the survival group (P <0.01). The AUC of MELD-Na and MELD in judging the 3-month survival time of patients were higher than that of Child-Pugh (P < 0.001, P <0.01). There was no significant difference in AUC between MELD-Na and MELD scores (P> 0.05). Conclusion MELD-Na is a better indicator of short-term prognosis in patients with decompensated cirrhosis. The accuracy of MELD-Na is better than that of Child-Pugh classification, but there is no significant difference between MELD-Na and MELD.