失代偿期肝硬化患者血清血管内皮生长因子水平检测的临床意义

目的评价血管内皮生长因子和终末期肝病模型评分对失代偿期肝硬化患者短期预后的判断价值。方法采用ELISA法检测84例失代偿期肝硬化患者血清血管内皮生长因子，并常规进行终末期肝病模型评分，探讨它们对预后判断的临床价值。结果在84例失代偿期肝硬化患者中，25例短期内死亡患者血清血管内皮生长因子水平为255．5±92．3pg/ml，终末期肝病模型计分为25．8±7．3，而存活患者则分别为130．3±100．3pg／ml和15．0±4．9（P〈0．005）；血清血管内皮生长因子水平与终末期肝病模型计分、凝血酶原时间呈正相关（r=-0．444，r=-0．443，P〈0．0001）；血清血管内皮生长因子与终末期肝病模型计分对预后判断的受试者工作特征曲线下面积分别为0．825和0．882，以血清血管内皮生长因子〉160．9pg／ml和终末期肝病模型计分〉22．9为最佳截断点，其对患者短期死亡判断的特异性为98．3％，准确率为88．1％。结论血清血管内皮生长因子水平和终末期肝病模型对失代偿期肝硬化患者的预后判断有重要的临床意义。

The short-term prognosis of patients with decompensated liver cirrhosis by serum vascular endothelial growth factor and model for end-stage liver disease

Objective To evaluate the short-term prognosis of patients with decompensated liver cirrhosis （DLC） by serum vascular endothelial growth factor （VEGF） and model for end-stage liver disease （MELD）. Methods Serum VEGF levels and MELD scores were assessed in 84 patients with DLC. Results The serum VEGF levels and MELD scores were both higher in patients died than in the survivals （P〈0.005）. There was a positive correlation between serum VEGF and MELD or PT（r=0.444,r=0.443,P〈0.0001 ）. The area under ROC curve was 0.882 in MELD score,while 0.825 in serum VEGF （P〉0.05）. Taking VEGF〉160.9pg/ml and MELD〉22.9 as a cut-off value,the specificity was 98.3% and the accuracy was 88.1%. Conclusion Serum VEGF level and MELD score have some clinical prognostic value in patients with DLC.