非酒精性脂肪肝相关性肝硬化患者肝功能不全的准确预测模型

2021-04-19 MedSci原创 MedSci原创

非酒精性脂肪肝疾病(NAFLD)是肝硬化和随后并发症的越来越重要的原因。

非酒精性脂肪肝疾病(NAFLD)是肝硬化和随后并发症的越来越重要的原因。
 
我们回顾性地开发并验证了一种预测NAFLD肝硬化患者肝失代偿的模型,并将其与当前可用的模型进行了比较。使用竞争风险多元回归和Akaike / Bayesian信息标准,研究了来自国际队列的299名经活检证实为肝硬化的NAFLD患者的基线变量,以构建模型。对来自美国的244例经活检证实的NAFLD肝硬化患者进行了验证。使用时间依赖性曲线下面积(tAUC)分析,将预后准确性与NAFLD纤维化评分(NFS),FIB-4,MELD,Child-Turcotte-Pugh(CTP)和ALBI-FIB-4评分进行比较。在中位随访5.6年(范围2.4-14.1)和5.4年(范围1.5-13.8)期间,分别在81名和132名患者中发生肝代偿失调。在派生队列中,将肝失代偿的独立预测因子(AST / ALT比,胆红素,国际标准化比,2型糖尿病和食管静脉曲张)合并到ABIDE模型中。得分≥4.1的受试者与得分<4.1的受试者相比,发生代偿失调的风险更高(sHR 6.7,95%CI 4.0-11.2,p <0.001),五年累积发生率更高(37%vs 6% ,p <0.001)和较短的平均失代偿时间(3.8 vs 6.7年,p <0.001)。在推导(tAUC 0.80,95%CI 0.73-0.84)和验证队列(0.78,95%CI 0.74-0.81)时,ABIDE模型在5年时的准确性都很好,并且比NFS(0.72)准确得多, FIB-4(0.74),MELD(0.69),CTP(0.72)和ALBI-FIB-4(0.73)(全部p <0.001)。

不同得分的风险曲线图
结论:在患有代偿性肝硬化的NAFLD患者中,ABIDE是常规临床措施的预测模型,可预测未来的肝代偿失调。

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  5. 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  6. 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  7. 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encodeId=9f6e1046485f2, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Mon Apr 19 14:02:13 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047909, encodeId=ba57104e909a7, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Apr 19 14:02:13 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958366, encodeId=7d0495836630, content=在患有代偿性肝硬化的NAFLD患者中,ABIDE是常规临床措施的预测模型,可预测未来的肝代偿失调。, beContent=null, objectType=article, channel=null, level=null, 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  8. 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likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b515466016, createdName=ms5000002050027133, createdTime=Mon Apr 19 14:01:50 CST 2021, time=2021-04-19, status=1, ipAttribution=)]
    2021-04-19 guging

    谢谢!最新的信息读起来就是收获大

    0

  9. 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likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b515466016, createdName=ms5000002050027133, createdTime=Mon Apr 19 14:01:50 CST 2021, time=2021-04-19, status=1, ipAttribution=)]
    2021-04-19 CHANGE

    梅斯里提供了很多疾病的模型计算公式,赞一个!

    0

  10. 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likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b515466016, createdName=ms5000002050027133, createdTime=Mon Apr 19 14:01:50 CST 2021, time=2021-04-19, status=1, ipAttribution=)]
    2021-04-19 ms5000002050027133

    在患有代偿性肝硬化的NAFLD患者中,ABIDE是常规临床措施的预测模型,可预测未来的肝代偿失调。

    0

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