血清降钙素原和常用炎症指标联合CTP评分对慢加急性肝衰竭短期预后的预测价值

发布时间：2019-05-10 06:22

【摘要】：目的探讨血清降钙素原(PCT)、常用炎症指标及CTP评分系统联合应用对慢加急性肝衰竭患者短期(3个月)预后的预测价值。方法收集2013年11月至2014年2月宁波市第二医院收治的72例慢加急性肝衰竭患者,分成生存组和死亡组,记录入院时的CTP评分,并检测患者的常用炎症指标及血清降钙素原(PCT),应用受试者工作特征曲线下面积(AUC)评价血清降钙素原(PCT)、常用炎症指标和CTP评分单项及联合应用对慢加急性肝衰竭患者短期预后的预测价值。结果生存组患者血清降钙素原(PCT)、常用炎症指标(白细胞计数、中性粒细胞百分比及计数、C反应蛋白)及CTP评分均显著低于死亡组(P均0.05)。ROC曲线结果显示,各指标对慢加急性肝衰竭的预后均有一定的诊断价值(P均0.05),但除了中性粒细胞百分比及计数、PCT、CTP评分显著优于白细胞计数外,其余指标之间的差异均不大(P均0.05)。Logistic回归分析结果表明,PCT、中性粒细胞百分比及CTP评分入选模型构建的指标,联合预测因子的ROC曲线下面积达到0.875。结论 PCT可用于慢加急性肝衰竭患者短期临床预后的预测,通过对多指标的联合运用可有效提高预测的准确性。
[Abstract]:Objective to evaluate the value of serum procalcitonin (PCT), inflammation index and CTP scoring system in predicting the short-term (3-month) prognosis of patients with chronic and acute liver failure. Methods from November 2013 to February 2014, 72 patients with chronic and acute liver failure were divided into survival group and death group. The CTP score at admission was recorded. Serum procalcitonin (PCT), was used to evaluate serum procalcitonin (PCT), using area (AUC) under the receiver operating characteristic curve to evaluate the serum procalcitonin (PCT),. Prediction of short-term prognosis of patients with chronic and acute hepatic failure by single and combined use of inflammatory index and CTP score. Results the common inflammatory indexes of serum procalcitonin (PCT), (white blood cell count, neutrophil percentage and count, C-reactive protein) and CTP score in survival group were significantly lower than those in death group (P0.05). All the indexes had certain diagnostic value for the prognosis of chronic and acute liver failure, but except for neutrophil percentage and count, PCT,CTP score was significantly better than leukocyte count. Logistic regression analysis showed that the percentage of PCT, neutrophils and CTP score were selected into the model and the area under the ROC curve of the combined predictors was 0.875. Conclusion PCT can be used to predict the short-term clinical prognosis of patients with chronic and acute liver failure, and the accuracy of prediction can be effectively improved by the combination of multiple indexes.
【作者单位】：宁波奉化市疾病预防控制中心;宁波市第二医院;武汉大学人民医院;
【基金】：国家973计划(2012CB518900) 宁波市科技局社会发展项目(2009C50025) 吴阶平医学基金会肝病医学部肝功能评价方法研究基金(LDWMF-PJ-2011A003)
【分类号】：R575.3

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