MELD评分与CTP分级评价人工肝治疗重型肝炎预后的对比研究

目的 比较终末期肝病模型（MELD）和Child-Turcotte-Pugh（CTP）分级对人工肝治疗重型肝炎预后的评估及其临床应用价值。方法回顾性分析111例重型肝炎的临床资料，根据是否行人工肝治疗分为人工肝组56例与对照组55例，分别计算两组患者治疗前后MELD评分和CTP分级，进行对比分析，观察3个月内的临床转归。结果MELD分值与实际病死率呈正相关，MELD评分越高，病死率越高，在CTP分级中，CTPC级治疗效果最差，人工肝治疗的效果也差。MELD分值在〈20、20～30和30～40三个范围内，人工肝组病死率分别为12．5％、48．0％和72．2％，对照组分别为13．3％、62．5％和85．7％，两组间比较差异有统计学意义（P〈0．05）。而MELD≥40分患者人工肝组与对照组的病死率均为100%，两组比较差异无统计学意义（P〉0．05）。结论MELD评分与CTP分级在人工肝治疗重型肝炎中具有预测作用。MELD评分和CTP分级各有特点，将两种评分方式有机结合互补不足，是符合临床实际的判断严重肝病预后较科学的手段之一。

Comparative and retrospective analysis of prognosis on patients with severe hepatitis treated with artificial liver support sys-tem using the model for end-stage liver disease and Child-Turcotte-Pugh score system

Objective To assess the different value and the clinical significance of model for end-stage liver disease (MEI.D)and Child Turcotte-Pugh(CTP)score for evaluation of the therapeutic effect of artificial liver support system (ALSS) on severe hepatitis.Methods A total of 111 patients with severe hepatitis were divided into 56 cases of treatment group(with ALSS) and 55 cases of control group(without ALSS).The MELD and CTP score were calculated respective and comparative analysis was performed.The death rate wa...