血清M30及M65水平用于HBV相关慢加急性肝衰竭患者预后的临床价值

摘要/Abstract

摘要： 目的探讨血清M30及M65水平用于乙型肝炎病毒(HBV)相关慢加急性肝衰竭(ACLF)患者短期预后的临床价值。方法纳入2013年2月至2016年10月住院的HBV相关ACLF患者101例(ACLF组),同时纳入慢性乙型肝炎(CHB)患者59例(CHB组)及健康对照57名(健康对照组)。记录患者一般情况及常规实验室指标,检测血清M30及M65水平。分析M30及M65水平与临床指标的相关性,ROC曲线及生存曲线分析评估指标的短期预后价值。结果 M30水平由高至低依次为ACLF组(1495.00±792.81) U/L、CHB组(943.78±538.87) U/L及健康对照组(705.00±278.56) U/L;血清M65水平由高至低依次为ACLF组(2519.93±1298.06) U/L、CHB组(1790.23±870.20) U/L及健康对照组(622.01±270.37) U/L。ACLF组中,M30水平与MELD评分(R=0.406,P＜0.001呈正相关,M65与MELD评分(R=0.526,P＜0.001)也呈正相关。M30单独预测90 d病死的AUC为0.794(95% CI:0.708～0.880),M65的AUC为0.785(95% CI:0.697～0.874)。M30联合MELD评分预测90 d病死的AUC为0.854(0.782～0.926),M65联合MELD评分的AUC为0.832(0.753～0.911),M30、M65及MELD评分三者联合的AUC为0.871(0.801～0.940)。结论血清M30及M65用于HBV相关ACLF患者短期的预后价值较高,M30及M65联合MELD评分可以提高预后效能。

关键词: 慢加急性肝衰竭, M30, M65, 终末期肝病模型, 预后

郭世民, 魏巍, 张自然, 李婧, 赵和平. 血清M30及M65水平用于HBV相关慢加急性肝衰竭患者预后的临床价值[J]. 肝脏, 2018, 23(7): 607-610.

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