MELD versus Child-Turcotte-Pugh score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt

LI Ling-min; XIAO Tian-li; CHEN Wen-sheng

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MELD versus Child-Turcotte-Pugh score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt

更新时间：2025-01-15

- MELD versus Child-Turcotte-Pugh score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt
- Journal of Army Medical University Vol. 31, Issue 8, Pages: 733-736(2009)
- 作者机构：
  
  第三军医大学西南医院全军消化病研究所
- 作者简介：
- 基金信息：
- DOI：
  CLC： R449;R181.2;R575.2
- Published：2009，
  
  Published Online：30 April 2009，
- 稿件说明：
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LI LING-MIN, XIAO TIAN-LI, CHEN WEN-SHENG. MELD versus Child-Turcotte-Pugh score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt. [J]. Journal of army medical university, 2009, 31(8): 733-736.
DOI：

LI LING-MIN, XIAO TIAN-LI, CHEN WEN-SHENG. MELD versus Child-Turcotte-Pugh score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt. [J]. Journal of army medical university, 2009, 31(8): 733-736. DOI：

摘要

目的评价终末期肝病评分模型（model for end-stage liver disease，MELD）与Child-Turcotte-Pugh（CTP）评分系统在肝硬化门脉高压患者行经颈静脉肝内门体静脉分流术（Transjugular intrahepatic portosystemic shunt， TIPS）的预后判断中的作用。方法收集我科2004年1月至2008年3月110例行TIPS术的门静脉高压患者基本资料、临床生化指标，计算MELD分值和CTP评分，并观察所有患者的临床转归，比较不同MELD评分（≤15分，＞15分）组及CTP分级（A、B和C级）组的生存率，通过ROC曲线下面积比较这2种模型在术后3个月、1年、2年预后中的预测作用。结果 ①MELD评分≤15分患者的生存率明显高于＞15分患者（

=0.0217），CTP评分为A、B、C级的患者生存率差异显著（

=0.0341）。②ROC曲线下面积在3个月时MELD为0.866，CTP为0.863；在1年时MELD为0.755，CTP为0.739；在2年时MELD为0.729，CTP为0.750，差异均无统计学意义（

>0.05）。结论 MELD与CTP均能较准确地预测TIPS患者的短期生存率，但MELD评分系统设计更客观、全面和科学，临床上值得推广应用。

Abstract

Objective To compare the predictive power of model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) on the cirrhotic patients who underwent transjugular intrahepatic portosystemic shunt (TIPS). Methods A total of 110 patients (98 males and 12 females) undergoing TIPS from January 2004 to March 2008 in our hospital were analyzed. Data of all patients were analyzed retrospectively. The main statistical tests included: Kaplan-Merier analysis to compare survival respectively

and the area of receiver operating characteristics (ROC) to compare the performance of the 2 models for predicting 3-month

1-year

and 2-year mortality. Results The survival rate rate of the patients whose MELD score under 15 showed significantly higher than the patients above MELD score 15. The area of ROC that predicting survival was 0.866 and 0.863 at 3 months

0.755 and 0.739 at 1-year

0.729 and 0.750 at 2-years respectively for the MELD and the CTP score. Conclusion Both MELD and CTP score can predict short-term survival accuracy

but poor in long-term. However

the MELD has overcome the shortcomings of CTP

and may be worth using in clinical.

关键词

门静脉高压经颈静脉肝内门体分流术终末期肝病模型

Keywords

portal hypertensiontransjugular intrahepatic portosystemic shuntmodel for end-stage liver disease

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