409例肝硬化和重型肝炎病例的MELD评分结果的构成分析

目的应用两种评分方法对409例肝硬化及重型肝炎患者进行评估比较，分析血清肌酐、血清胆红素及凝血酶原时间国际标准化比值（INR）对MELD评分结果的影响程度。方法统计409例肝硬化及重型肝炎患者的相关资料，应用Child和MELD评分法分别计算后应用Chiss软件进行统计学分析。结果随着A、B、C、D各个级别的病情的加重，MELD评分明显升高。各个级别的血清胆红素、INR之间存在明显差异；各个级别的血清肌酐之间无明显差异。结论血清胆红素及凝血酶原时间国际标准化比值（INR）的变化及不同能够明显影响到评分结果，而血清肌酐的结果对评分结果的影响不显著。MELD应与多因素分析及临床经验有机结合，才是符合临床实际的判断严重肝病预后的较科学手段。

Analysis of the result of 409 cases with liver cirrhosis and severe hepatitis by using the model for end-stage liver disease

Objective To analyze the influence of the model for end-stage liver disease (MELD) results in 409 cases with liver cirrhosis and severe hepatitis and compare with Child-Pugh scoring system. Methods The data of 409 patients with liver cirrhosis and severe hepatitis were collected and analyzed by using the Child-Pugh and MELD scoring systems, and Chiss statistical software was applied.Results There is a statistical significance between either results of MELD of group A, B, C, D; there is a statistical significance between either group in total serum bilirubin and creatinine,but not in INR.Conclusion The changes in total serum bilirubin and creatinine can influence the result significantly, not the INR, and a better way to predict the prognosis of severe liver disease may be application of MELD combined with clinical experience.