MELD、MESO、iMELD 对失代偿期肝硬化患者短期预后的评估价值

目的 评估终末期肝病模型（MELD）、终末期肝病模型与血清钠比值（MESO）、综合终末期肝病模型评分（iMELD）对失代偿期肝硬化患者短期预后的价值。方法 分别计算112 例失代偿期肝硬化患者的MELD、MESO、iMELD 分值，运用ROC 曲线及曲线下面积（AUC）比较3 种评分系统判断失代偿期肝硬化患者短期预后的价值。结果 112 例患者随访3 和6 个月的死亡组与生存组的MELD、MESO、iMELD评分比较差异有统计学意义。随访3 和6 个月患者的ROC 曲线AUC 比较，iMELD 评分>MESO 评分>MELD 评分（P <0.05）。结论 MELD、MESO、iMELD 评分均可有效地预测失代偿期肝硬化患者的短期预后，iMELD 评分优于MESO 评分，MESO 评分优于MELD 评分，经改良后的MELD 能够提高临床预测能力，具有更高的临床应用价值。

Value of MELD, MESO and iMELD in evaluation of short-termprognosis of patients with decompensated liver cirrhosis

Objective To evaluate the clinical value of model for end-stage liver disease (MELD), MELDto serum sodium ratio (MESO) and integrated MELD (iMELD) in prediction of short-term prognosis of patientswith decompensated liver cirrhosis. Methods MELD, MESO and iMELD scores were assessed in 112 patientswith decompensated liver cirrhosis. The accuracy of the three scoring systems in predicting survival was analyzedand compared using the area under the receiver operating characteristic (ROC) curve (AUC). Results There weresignificant differences in MELD, MESO and iMELD scores between the death group and the survival group afterfollow-up for 3 and 6 m. The AUC value of iMELD score was higher than those of MESO and MELD scores,the AUC value of MESO score was higher than that of MELD score after follow-up for 3 and 6 m (P < 0.05).Conclusions MELD, MESO and iMELD scores can accurately predict the short-term prognosis in patients withdecompensated liver cirrhosis, while iMELD score is superior to the MESO score, and MESO score is superior to theMELD score.