APRI评分及FIB-4指数在慢性肝衰竭预后评估中的应用价值研究

发布时间：2018-02-26 18:22

本文关键词： APRI FIB-4 肝衰竭预后　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探究APRI评分及FIB-4指数在慢性肝衰竭预后评估中的应用价值。方法:回顾性分析2005年3月至2014年9月随访期满3个月的新疆医科大学第一附属医院感染性疾病中心426例慢性肝衰竭患者资料,计算患者诊断为慢性肝衰竭时的MELD评分、APRI评分及FIB-4指数。应用单因素及多因素分析,绘制受试者工作特征曲线(ROC曲线),评价各评分方法预测患者3个月预后的价值。结果:单因素分析显示APRI评分在生存组和死亡组之间差异无统计学意义(P0.05),FIB-4指数在生存组和死亡组之间差异有统计学意义(P0.05),多因素分析示APRI评分及FIB-4指数在生存组和死亡组之间均有统计学意义(P0.05);MELD评分、APRI评分、FIB-4指数AUC分别为0.6353、0.4888、0.6162,MELD评分和FIB-4指数与APRI评分间差异有统计学意义(P0.05),其中MELD评分及FIB-4指数间差异无统计学意义(P0.05),当MELD评分大于28分、FIB4指数大于11.27分时患者3个月病死率高,预后差;426例患者中,FIB-43.25者(n=59),病死率为33.9%,大于3.25者共367例,病死率为61.04%,差异有统计学意义(P0.05)。结论:APRI评分在评估慢性肝衰竭预后未显示应用价值,FIB-4指数在慢性肝衰竭预后评估中有应用价值,其预测慢性肝衰竭价值不差于MELD评分,且FIB-4指数越高,慢性肝衰竭预后越差。
[Abstract]:Objective: to explore the value of APRI score and FIB-4 index in evaluating the prognosis of chronic liver failure. Methods: the infectious diseases in the first affiliated Hospital of Xinjiang Medical University were analyzed retrospectively from March 2005 to September 2014. Data of 426 patients with chronic liver failure, The MELD score and FIB-4 index of the patients with chronic liver failure were calculated. Univariate and multivariate analysis were used. Results: univariate analysis showed that there was no significant difference in APRI score between survival group and death group. There was significant difference between survival group and death group (P 0.05). Multivariate analysis showed that APRI score and FIB-4 index were statistically significant between survival group and death group. AUC of AUC was 0.63530.48880.86162meld, FIB-4 index and APRI. There was no significant difference between MELD score and FIB-4 index (P 0.05). When the MELD score was more than 28 points and the FIB4 index was greater than 11.27, the mortality rate was higher in 3 months. In 426 patients with poor prognosis, there were 43.25 cases with FIB-43.25 and 367 cases with fatality rate of 33.9and more than 3.25, respectively. The mortality rate was 61.04, and the difference was statistically significant (P 0.05). Conclusion the value of FIB-4 index in evaluating the prognosis of chronic liver failure is not significant. The value of FIB-4 index in predicting the prognosis of chronic liver failure is not worse than that of MELD score. The higher the FIB-4 index, the worse the prognosis of chronic liver failure.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.3

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