INR和MELD评分对并发肝性脑病的肝硬化患者短期预后的预测价值

被引:0
作者
胡小鹏
机构
[1] 重庆医科大学
关键词
肝硬化; 肝性脑病; 再入院; 死亡; 多因素分析;
D O I
暂无
年度学位
2019
学位类型
硕士
导师
摘要
目的:明确肝硬化患者肝性脑病得到控制后早期(30天)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(INR)水平(比值比为2.40;P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%vs.20%;?2值为14.335,P<0.001)。出院时的终末期肝病模型(MELD)评分(比值比为1.11;P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;P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;P值为0.021)可独立预测中期死亡的发生。结论:INR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。同时,贫血是预防早期再入院的潜在治疗靶点。
引用
收藏
页数:32
共 24 条
[1]
肝衰竭诊治指南(2018年版).[J]..临床肝胆病杂志.2019, 01
[2]
Targeted and Immune-based Therapies for Hepatocellular Carcinoma.[J].Tim F. Greten;Chunwei Walter Lai;Guangfu Li;Kevin F. Staveley-O’Carroll.Gastroenterology.2018, 2
[3]
Targeting Programmed Cell Death -1 (PD-1) and Ligand (PD-L1): A new era in cancer active immunotherapy.[J].Anastasia Constantinidou;Constantinos Alifieris;Dimitrios T. Trafalis.Pharmacology and Therapeutics.2018,
[4]
Molecularly targeted anti-cancer drugs inhibit the invasion and metastasis of hepatocellular carcinoma by regulating the expression of MMP and TIMP gene families.[J].Xiao-xiao He;Liang-liang Shi;Meng-jun Qiu;Qiu-ting Li;Meng-meng Wang;Zhi-fan Xiong;Sheng-li Yang.Biochemical and Biophysical Research Communicatio.2018,
[5]
Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib (KEYNOTE-224): a non-randomised, open-label phase 2 trial [J].
Zhu, Andrew X. ;
Finn, Richard S. ;
Edeline, Julien ;
Cattan, Stephane ;
Ogasawara, Sadahisa ;
Palmer, Daniel ;
Verslype, Chris ;
Zagonel, Vittorina ;
Fartoux, Laetitia ;
Vogel, Arndt ;
Sarker, Debashis ;
Verset, Gontran ;
Chan, Stephen L. ;
Knox, Jennifer ;
Daniele, Bruno ;
Webber, Andrea L. ;
Ebbinghaus, Scot W. ;
Ma, Junshui ;
Siegel, Abby B. ;
Cheng, Ann-Lii ;
Kudo, Masatoshi .
LANCET ONCOLOGY, 2018, 19 (07) :940-952
[6]
Targeting the microenvironment in solid tumors.[J].Carmen Belli;Dario Trapani;Giulia Viale;Paolo D'Amico;Bruno Achutti Duso;Paolo Della Vigna;Franco Orsi;Giuseppe Curigliano.Cancer Treatment Reviews.2018,
[7]
Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial.[J].Masatoshi Kudo;Richard S Finn;Shukui Qin;Kwang-Hyub Han;Kenji Ikeda;Fabio Piscaglia;Ari Baron;Joong-Won Park;Guohong Han;Jacek Jassem;Jean Frederic Blanc;Arndt Vogel;Dmitry Komov;T R Jeffry Evans;Carlos Lopez;Corina Dutcus;Matthew Guo;Kenichi Saito;Silvija Kraljevic;Toshiyuki Tamai;Min Ren;Ann-Lii Cheng.The Lancet.2018, 1012
[8]
Managing the adverse events associated with lenvatinib therapy in radioiodine-refractory differentiated thyroid cancer [J].
Cabanillas, Maria E. ;
Takahashi, Shunji .
SEMINARS IN ONCOLOGY, 2019, 46 (01) :57-64
[9]
Immune checkpoint blockade and its combination therapy with small-molecule inhibitors for cancer treatment [J].
Wang, Manni ;
Liu, Yu ;
Cheng, Yuan ;
Wei, Yuquan ;
Wei, Xiawei .
BIOCHIMICA ET BIOPHYSICA ACTA-REVIEWS ON CANCER, 2019, 1871 (02) :199-224
[10]
Biomarkers of response to PD-1/PD-L1 inhibition.[J].Saman Maleki Vareki;Carmen Garrigós;Ignacio Duran.Critical Reviews in Oncology / Hematology.2017,