关键词: 乙肝, 肝衰竭, 评分系统

Abstract: Objective To study the predictive value of different scoring systems for the risk of chronic hepatitis B patients with acute on chronic liver failure. Methods The clinical data of 94 patients with chronic hepatitis B and acute on chronic liver failure were selected and divided into the early group, the middle group and the late group according to the stages of liver failure. In addition, 30 patients with severe chronic hepatitis B admitted to our hospital at the same time were selected and set as the group without liver failure. After admission, all patients were evaluated by end-stage renal disease model (MELD), serum sodium concentration MELD integrated model(MELD-Na), end-stage renal disease model and serum sodium ratio (MESO), iMELD model scoring system (iMELD), sequential organ liver failure evaluation model (SOFA) before treatment. In addition, the ROC curve was used to analyze the value of five scores in predicting chronic hepatitis B patients with acute on chronic liver failure. Results In comparison of the five scores, there was a significant difference between the late group, the middle group, the early group and the non-liver failure group (P<0.05). According to ROC analysis, the area under the curve of predicting chronic hepatitis B patients with acute on chronic liver failure was 0.938, 0.976, 0.960, 0.902 and 0.903 respectively, and the sensitivity of MELD, MELD Na and iMELD to predict chronic hepatitis B patients with acute on chronic liver failure (0.989, 0.947, 0.968) was higher than that of MESO and SOFA (0.670, 0.809). Conclusion ROC curve has confirmed that MELD, MELD-Na, iMELD, MESO and SOFA scores can help in the early diagnosis of chronic hepatitis B and acute on chronic liver failure.

Key words: Hepatitis B, Liver failure, Grading system