血清钠与MELD的联合公式评估肝硬化患者预后的能力

目的 评价血清钠与终末期肝病模型的联合公式（MELD-Na）在评估我国肝硬化患者预后方面的能力。 方法 选择具有完整临床资料和随访结果的216例肝硬化患者进行回顾性分析。采用寿命表法计算生存率，采用受试者工作特征曲线(ROC曲线)及其下面积（AUC）评价MELD-Na评估预后的能力。 结果 将患者依据MELD-Na值分成3组后，不同分组间的生存率均存在明显差异（P = 0.000）。MELD-Na在判断患者3个月、6个月、1年等生存时间的ROC曲线的AUC均大于0.8，但均小于MELD相应的AUC。 结论 MELD-Na在判断我国肝硬化患者预后方面是一个很好的指标，但与MELD相比，并无优势。

The capability of the formula combined with serum sodium and MELD in predicting the prognosis of Chinese patients with liver cirrhosis

Objective To evaluate the capability of the formula combined with serum sodium and the model for end-stage liver disease(MELD-Na) in predicting the prognosis of Chinese patients with liver cirrhosis. Methods A cohort of 216 patients with liver cirrhosis were retrospectively studied and followed up. Life tables were used to calculate the survival rate. The area under the receiver operating characteristic(ROC) curve(AUC) was used to evaluate the capability of MELD-Na in predicting the prognosis. Results In the subgroups of patients ranked by MELD-Na lower than 10, 10 to 20, more than 20, the survival rate was significant different(P = 0.000). The AUC values generated by the ROC curves for the MELD-Na were 0.833, 0.836 and 0.873 respectively in predicting 3, 6 month and 1 year survival, and were all more than 0.800, but less than the corresponding AUCs of MELD. Conclusion MELD-Na is a useful prognosis indictor for the liver cirrhosis. But the ability of prognosis by MELD-Na is not better than MELD alone.