妊娠期急性脂肪肝患者预后相关危险因素分析及预测模型建立

发布时间：2018-09-05 18:10

【摘要】：目的:探讨妊娠期急性脂肪肝(AFLP)患者预后相关的危险因素,并建立预测模型。方法:回顾性分析93例中南大学湘雅医院和湘雅二医院收治的AFLP患者,通过单因素和多因素Logistic回归分析死亡预测因素,并建立预测模型,联合比值比及受试者工作特征曲线(ROC曲线)比较不同因子的预测价值。结果:单因素分析显示国际标准化比值(INR)、总胆红素(TBIL)、血肌酐(Scr)、血小板计数(PLT)以及出现肝性脑病是AFLP患者病死的独立危险因素。多因素分析联合各项危险因素,以肝性脑病和PLT建立AFLP预后预测模型,其预测效能为87.0%,灵敏度为81.8%,特异度为76.8%。结论:TBIL、INR、Scr增加,PLT减少及出现严重肝性脑病是AFLP患者死亡的独立危险因素;建立的AFLP预后预测模型具有较高的预测效能。
[Abstract]:Objective: to investigate the prognostic risk factors of acute fatty liver disease (AFLP) during pregnancy and to establish a predictive model. Methods: a retrospective analysis of 93 cases of AFLP patients admitted to Xiangya Hospital and Xiangya II Hospital of Central South University was made. Single and multivariate Logistic regression analysis was used to predict the death factors, and a predictive model was established. The combined ratio and the operating characteristic curve (ROC curve) were used to compare the predictive value of different factors. Results: univariate analysis showed that international standardized ratio (INR), total bilirubin (TBIL), serum creatinine (Scr), platelet count (PLT) and hepatic encephalopathy were independent risk factors for death of AFLP patients. Multivariate analysis combined with various risk factors was used to establish a prognostic model of AFLP with hepatic encephalopathy and PLT. The predictive efficiency was 87.0, the sensitivity was 81.8, and the specificity was 76.8. Conclusion the increase of AFLP and the occurrence of severe hepatic encephalopathy are independent risk factors of death in patients with AFLP, and the prognostic prediction model of AFLP has high predictive efficacy.
【作者单位】：中南大学湘雅医院妇产科;中南大学湘雅医学院临床医学系;中南大学湘雅二医院妇产科;
【基金】：国家“十二五”科技支撑计划项目(2014BAI05B05) 中南大学湘雅医院临床科研基金(2013L10) 中南大学湘雅临床大数据建设项目(87)~~
【分类号】：R714.255

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