3种模型系统对HBV相关慢加急性肝衰竭人工肝治疗短期预后的评估价值

目的：评价中国重型乙型肝炎研究组慢加急性肝衰竭评分系统(COSSH-ACLF)、肝病终末期模型(MELD)、亚太肝病研究学会研究联盟慢加急性肝衰竭评分系统(AARC-ACLF)3种模型系统对乙肝病毒相关性慢加急性肝衰竭(HBV-ACLF)人工肝治疗短期预后的价值。方法：收集2017年7月至2020年11月在蚌埠医学院第一附属医院住院并行人工肝治疗的HBV-ACLF病人44例，其中好转组27例，进展组17例，并对2组间相关指标和模型系统评分进行比较，对P<0.05的指标绘制ROC曲线，比较曲线下面积(AUC)。结果：进展组凝血国际标准化比值(INR)与MELD、COSSH-ACLF、AARC-ACLF三种综合评分系统评分均高于好转组，差异有统计学意义(P<0.05～P<0.01)。ROC曲线分析显示，INR与MELD、COSSH-ACLF、AARC-ACLF三种模型系统对行人工肝治疗的HBV-ACLF病人短期预后均具有良好的预测价值(AUC分别为0.801、0.834、0.796、0.709,P<0.05～P<0.01),且三种模型系统之间的差异无统计学意义...

Value of three model systems in short-term prognosis of artificial liver in treatment of patients with hepatitis B virus related acute-on-chronic liver failure

ObjectiveTo investigate the value of COSSH-ACLF, MELD and AARC-ACLF model in short-term prognosis of artificial liver in treatment of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).MethodsA total of 44 patients who were diagnosed HBV-ACLF collected in July 2017 to November 2020 in the First Affiliated Hospital of Bengbu Medical College and performed artificial liver therapy were selected, including improvement group (27 cases) and progression group (17 cases).The correlation indexes and the model system score were compared between the two groups.ROC curves were drawn for indexes with P < 0.05, and the area under the curve (AUC) was compared.ResultsThe scores of international standardized ratio (INR) and MELD, COSSH-ACLF, AARC-ACLF comprehensive scoring systems in the progression group were higher than those in the improvement group, and the differences were all statistically significant (P < 0.05 to P < 0.01).ROC curve analysis showed that INR and MELD, COSSH-ACLF, AARC-ACLF model systems had good predictive value for short-term prognosis of patients with HBV-ACLF treated with artificial liver (AUC was 0.801, 0.834, 0.796, 0.709, respectively, P < 0.05 to P < 0.01), and there was no significant difference between the three model systems (P>0.05).ConclusionsAll three model systems have a good predictive effect on the prognosis of HBV-ACLF patients receiving artificial liver treatment.