發(fā)布時(shí)間：2018-02-26 18:22

  本文關(guān)鍵詞： APRI FIB-4 肝衰竭 預(yù)后　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:探究APRI評(píng)分及FIB-4指數(shù)在慢性肝衰竭預(yù)后評(píng)估中的應(yīng)用價(jià)值。方法:回顧性分析2005年3月至2014年9月隨訪(fǎng)期滿(mǎn)3個(gè)月的新疆醫(yī)科大學(xué)第一附屬醫(yī)院感染性疾病中心426例慢性肝衰竭患者資料,計(jì)算患者診斷為慢性肝衰竭時(shí)的MELD評(píng)分、APRI評(píng)分及FIB-4指數(shù)。應(yīng)用單因素及多因素分析,繪制受試者工作特征曲線(xiàn)(ROC曲線(xiàn)),評(píng)價(jià)各評(píng)分方法預(yù)測(cè)患者3個(gè)月預(yù)后的價(jià)值。結(jié)果:單因素分析顯示APRI評(píng)分在生存組和死亡組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),FIB-4指數(shù)在生存組和死亡組之間差異有統(tǒng)計(jì)學(xué)意義(P0.05),多因素分析示APRI評(píng)分及FIB-4指數(shù)在生存組和死亡組之間均有統(tǒng)計(jì)學(xué)意義(P0.05);MELD評(píng)分、APRI評(píng)分、FIB-4指數(shù)AUC分別為0.6353、0.4888、0.6162,MELD評(píng)分和FIB-4指數(shù)與APRI評(píng)分間差異有統(tǒng)計(jì)學(xué)意義(P0.05),其中MELD評(píng)分及FIB-4指數(shù)間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),當(dāng)MELD評(píng)分大于28分、FIB4指數(shù)大于11.27分時(shí)患者3個(gè)月病死率高,預(yù)后差;426例患者中,FIB-43.25者(n=59),病死率為33.9%,大于3.25者共367例,病死率為61.04%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:APRI評(píng)分在評(píng)估慢性肝衰竭預(yù)后未顯示應(yīng)用價(jià)值,FIB-4指數(shù)在慢性肝衰竭預(yù)后評(píng)估中有應(yīng)用價(jià)值,其預(yù)測(cè)慢性肝衰竭價(jià)值不差于MELD評(píng)分,且FIB-4指數(shù)越高,慢性肝衰竭預(yù)后越差。
[Abstract]:Objective: to explore the value of APRI score and FIB-4 index in evaluating the prognosis of chronic liver failure. Methods: the infectious diseases in the first affiliated Hospital of Xinjiang Medical University were analyzed retrospectively from March 2005 to September 2014. Data of 426 patients with chronic liver failure, The MELD score and FIB-4 index of the patients with chronic liver failure were calculated. Univariate and multivariate analysis were used. Results: univariate analysis showed that there was no significant difference in APRI score between survival group and death group. There was significant difference between survival group and death group (P 0.05). Multivariate analysis showed that APRI score and FIB-4 index were statistically significant between survival group and death group. AUC of AUC was 0.63530.48880.86162meld, FIB-4 index and APRI. There was no significant difference between MELD score and FIB-4 index (P 0.05). When the MELD score was more than 28 points and the FIB4 index was greater than 11.27, the mortality rate was higher in 3 months. In 426 patients with poor prognosis, there were 43.25 cases with FIB-43.25 and 367 cases with fatality rate of 33.9and more than 3.25, respectively. The mortality rate was 61.04, and the difference was statistically significant (P 0.05). Conclusion the value of FIB-4 index in evaluating the prognosis of chronic liver failure is not significant. The value of FIB-4 index in predicting the prognosis of chronic liver failure is not worse than that of MELD score. The higher the FIB-4 index, the worse the prognosis of chronic liver failure.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R575.3

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