The application of serum endotoxin combined with integrated model for end-stage liver disease in evaluating the short and medium term prognosis of patients with decompensated liver cirrhosis
10.3760/cma.j.issn.1673-4904.2014.31.007
- VernacularTitle:血清内毒素与整合终末期肝病模型在判断失代偿期肝硬化患者中短期预后中的应用
- Author:
Yufeng LIU
;
Hui FAN
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Endotoxins;
Integrated model for end-stage liver disease
- From:
Chinese Journal of Postgraduates of Medicine
2014;37(31):18-21
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the application value of serum endotoxin combined with integrated model for end-stage liver disease (iMELD) in evaluating the short and medium term prognosis of patients with decompensated liver cirrhosis.Methods The clinical data of 68 patients with decompensated liver cirrhosis were retrospectively analyzed.The patients were divided into survival group and death group according to the result of follow-up at the 3,6 and 12 months.The iMELD score and Child-Turcotte-Pugh (CTP) score were calculated according to relevant indicators,and the serum endotoxin level was detected.The correlation between serum endotoxin and iMELD score was analyzed in the short and medium term prognosis in patients with decompensated liver cirrhosis.Results After 3 months' follow-up,5 patients died.The iMELD scores in survival group and death group were (39.26 ± 7.29) and (49.29 ± 8.63) scores,CTP scores were (9.32 ± 2.12) and (12.03 ± 2.75) scores,serum endotoxin levels were (9.21 ± 2.24) and (15.39 ± 5.12) ng/L,and there were statistical differences (P ＜ 0.05).After 6 months'follow-up,12 patients died.The iMELD scores in survival group and death group were (41.35 ± 8.03) and (52.18 ± 10.37) scores,CTP scores were (9.78 ± 2.05) and (12.93 ± 1.99) scores,serum endotoxin levels were (8.96 ± 2.41) and (16.43 ±6.03) ng/L,and there were statistical differences (P ＜0.05).After 12 months' follow-up,19 patients died.The iMELD scores in survival group and death group were (40.74 ± 6.38) and (52.29 ± 8.53) scores,CTP scores were (10.01 ± 2.23) and (13.27 ± 1.69) scores,serum endotoxin levels were (8.53 ± 2.34) and (16.52 ± 6.08) ng/L,and there were statistical differences (P ＜ 0.05).The area under curve of receiver operating characteristic (ROC) was 0.952,standard error was 0.048,and 95％ confidence interval was 0.790-1.022.The best critical value of iMELD score to predict death was ≥48.00 scores,and the risk of death would rise if iMELD score was increased.The best critical value of serum endotoxin to predict death was ≥ 11.00 ng/L.Conclusion iMELD score and serum endotoxin have important value in predicting prognosis in patients with decompensated liver cirrhosis.
