国际标准化比值和终末期肝病模型评分对并发肝性脑病的肝硬化患者短期预后的预测价值

胡小鹏; 高建

doi:10.16016/j.1000-5404.201901232

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国际标准化比值和终末期肝病模型评分对并发肝性脑病的肝硬化患者短期预后的预测价值

临床医学 | 更新时间：2026-01-09

- 国际标准化比值和终末期肝病模型评分对并发肝性脑病的肝硬化患者短期预后的预测价值
- International normalized ratio and model for end-stage liver disease score for predicting short-term prognosis of cirrhotic patients with hepatic encephalopathy
- 第三军医大学学报 2019年41卷第14期页码：1374-1380
- 作者机构：
  
  400010 重庆，重庆医科大学附属第二医院消化内科
- 作者简介：
  
  [ 高建，E-mail：982213482@qq.com GAO Jian, E-mail:982213482@qq.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201901232
  中图分类号： R181.23; R575.207; R747.9
- 收稿：2019-01-29，
  
  修回：2019-03-04，
  
  纸质出版：2019-07-30
- 稿件说明：
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胡小鹏, 高建. 国际标准化比值和终末期肝病模型评分对并发肝性脑病的肝硬化患者短期预后的预测价值[J]. 第三军医大学学报, 2019,41(14):1374-1380.

Xiaopeng HU, Jian GAO. International normalized ratio and model for end-stage liver disease score for predicting short-term prognosis of cirrhotic patients with hepatic encephalopathy[J]. Journal of Third Military Medical University, 2019, 41(14): 1374-1380.
胡小鹏, 高建. 国际标准化比值和终末期肝病模型评分对并发肝性脑病的肝硬化患者短期预后的预测价值[J]. 第三军医大学学报, 2019,41(14):1374-1380. DOI： 10.16016/j.1000-5404.201901232.

Xiaopeng HU, Jian GAO. International normalized ratio and model for end-stage liver disease score for predicting short-term prognosis of cirrhotic patients with hepatic encephalopathy[J]. Journal of Third Military Medical University, 2019, 41(14): 1374-1380. DOI： 10.16016/j.1000-5404.201901232.

摘要

目的

明确肝硬化患者肝性脑病得到控制后早期(30 d)再入院和中期(6个月)死亡的预测因素，以便于临床早期干预，降低早期再入院率及中期死亡率。

方法

纳入213例因肝性脑病住院的肝硬化患者，并随访6个月。

结果

出院时的国际标准化比值(international normalized ratio

INR)水平(比值比为2.40；

值为0.003)可独立预测早期再入院的发生。出院时INR＞1.62较INR≤1.62的患者早期再入院风险显著增高(44%

20%；

值为14.335，

0.001)。出院时的终末期肝病模型(model for end-stage liver disease，MELD)评分(比值比为1.11；

值为0.048)可独立预测肝性脑病引起的早期再入院的发生。出院时的血红蛋白水平(比值比为0.97；

值为0.005)是早期再入院发生的保护因素。此外，住院期间使用人工肝(风险比为6.67；

值为0.021)可独立预测中期死亡的发生。

结论

国际标准化比值可用于识别早期再入院率较高的肝硬化患者，MELD评分可用于预测肝性脑病的早期复发。

Abstract

Objective

To determine the predictors of early readmission (30 d) and mid-term mortality (6 months) in cirrhotic patients discharged after hepatic encephalopathy (HE) is controlled.

Methods

A total of 213 cirrhotic patients with HE

who were discharged after HE was controlled

were enrolled in the study and followed up for 6 months. The early readmission within 30 d after discharge and the mid-term (in 6 months) mortality of the patients were recorded

and the predictors of the short-term prognosis were analyzed.

Results

The international normalized ratio (INR) [odds ratio (

)=2.40

=0.003

]

at discharge independently predicted the early readmission of the patients. The incidence of early readmission was significantly higher in patients with an INR

1.62 at discharge than in those with an INR ≤1.62 (44%

20%

Chi

-square=14.335

0.001). The model for end-stage liver disease (MELD) score at discharge was an independent predictor of early readmission associated with HE (

=1.11

=0.048). Hemoglobin at discharge was an independent predictor of non-early readmission (

=0.97

=0.005). The use of an artificial liver during the first hospit

alization independently predicted the mid-term mortality of the patients after discharge [hazard ratio (

)=6.67

=0.021

]

Conclusion

For cirrhotic patients with HE

INR can be applied to identify those at a high risk of early readmission

and MELD score is capable of predicting early relapse of HE after discharge.

关键词

Keywords

references

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