MELD评分联合血清高密度脂蛋白胆固醇水平预测非酒精性肝硬化预后

目的评估终末期肝病模型(model for end-stage liver disease,MELD)联合血清高密度脂蛋白胆固醇(HDL-C)水平对预测肝硬化肝功能失代偿期患者的短期、中期死亡危险的价值。方法入选57例非酒精性肝硬化肝功能失代偿期患者,分别根据随访6月及12月的存活情况分组,观察死亡者与存活者中血清HDL-C值、MELD评分。结果随访至6月及12月,死亡者血清HDL-C显著低于存活者,MELD评分显著高于存活者,均具有统计学差异(均P<0.01)。MELD评分与HDL-C密切相关(r=-0.96,P<0.01)。MELD评分联合血清HDL-C预测6个月死亡敏感性100.0%,特异性92.1%。结论MELD评分系统、血清HDL-C水平是预测非酒精性肝硬化患者6个月、12个月生存率的独立的较好预后指标。MELD评分联合血清HDL-C水平在预测非酒精性肝硬化肝功能失代偿期患者短、中期死亡率方面具有更好的作用。

Prognostic evaluation of non-alcoholic cirrhotic patients by means of MELD score combined with HDL-ch levels

Objective To evaluate the prognosis of non-alcoholic cirrhotic patients by means of model for end-stage liver disease (MELD) combined with high-density lipoprotein cholesterol (HDL-ch). Methods A total of 57 non-alcoholic cirrhotic patients were followed-up, the fatality within six months and within 12 months was recorded. The serum HDL-ch levels and the MELD score were investigated retrospectively for each patient. Results The HDL-ch levels and MELD were significantly different between surviving and fatal cases. In predicting fatality in six months MELD score combined with HDL-ch showed a sensitivity of 100% and a specificity of 92.1%. MELD score was significantly correlated with HDL-ch levels (r=-0.96, P<0.01). Conclusion The MELD score combined with serum HDL-ch levels might be an useful predictor of short and medium-term mortality in non-alcoholic cirrhotic patients.