J Gastroenterol Hepatol：在慢加急性肝衰竭患者中，验证预测短期死亡率系统的诊断效能

2017-11-29 MedSci MedSci原创

CLIF-SOFAs， CLIF-C OFs和CLIF-C ACLFs是有用的评分系统，可以为CLIF-C定义的ACLF患者提供预后信息，而没有为AARC定义判定的ACLF患者提供相关预后信息。

研究背景：本研究的目的是在韩国慢性肝病患者中验证慢性肝脏衰竭序贯器官衰竭评估评分(CLIF-SOFAs)，慢性肝脏衰竭联合器官衰竭评分(CLIF-C OFs) 慢性肝脏衰竭联合慢加急性肝衰竭(CLIF-C ACLFs)，慢性肝脏衰竭联合急性呼吸困难评分(CLIF-C ADs)等。

研究方法：慢加急性肝衰竭（ACLF）由肝脏ACLF研究联盟(AARC)的亚洲太平洋协会或者CLIF-C标准定义。通过受试工作曲线下面积(AUROC) 评估各评分系统的诊断表现。

研究结果：1470例患者中，有252例患者被诊断为ACLF，通过CLIF-C诊断为ACLF的患者有197例，通过AARC标准诊断的患者有95例。随着ACLF级别增加，患者生存率显著下降。根据CLIF-C诊断标准，被诊断为ACLF的患者，其CLIF-SOFAs， CLIF-C OFs和 CLIF-C ACLFs的受试工作曲线下面积显著高于Child-Pugh，终末期肝病模型(MELD)和MELD-Na评分(所有P<0.05)；但是，根据AARC标准进行疾病判读，ACLF患者和非ACLF患者，CLIF-SOFAs， CLIF-C OFs和 CLIF-C ACLFs与Child-Pugh，终末期肝病模型(MELD)和MELD-Na评分没有显著性差异。根据CLIF-C 标准定义的ACLF患者，在明显性固定的前体下，相比肝脏特异性评分，CLIF-SOFAs， CLIF-C Ofs和 CLIF-C ACLFs有更高的特异性；然而，由AARC标准定义的ACLF患者，没有类似的结果。

研究结论：CLIF-SOFAs， CLIF-C OFs和CLIF-C ACLFs是有用的评分系统，可以为CLIF-C定义的ACLF患者提供预后信息，而没有为AARC定义判定的ACLF患者提供相关预后信息。

原始出处

Song DS， Kim TY， Kim DJ， et al. Validation of Prognostic Scores to Predict Short-term Mortality in Patients with Acute-on-Chronic Liver Failure.J Gastroenterol Hepatol， 2017， Sep 16. doi： 10.1111/jgh.13991.

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2018-09-10 许安

#GAS#

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2018-09-13 ms24272190615788285182

#AST#

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2018-09-29 jktdtl

#Gastroenterol#

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2018-10-27 1249884fm94暂无昵称

#肝衰#

34 0
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2017-12-01 xlysu

#急性肝衰竭#

22 0
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2017-12-01 redcrab

#慢加急性肝衰竭#

29 0
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2017-12-01 gwc384

#EPA#

26 0

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