【摘要】 目的探讨MELD评分及Child-Pugh分级对失代偿期肝硬化患者预后评估的应用价值。方法回顾性分析2000-01～2004-11北京大学人民医院收治的失代偿期肝硬化患者41例死亡病例及71例好转出院病例MELD评分及Child-Pugh分级并进行比较。结果MELD分值死亡者(17.93±8.22),出院者(11.18±6.54)(t=4.781,P=0.000)。Child-Pugh分值死亡者(10.07±1.84),出院者(8.04±2.09)(t=5.179,P=0.000)。MELD≤9分者占死亡患者的14.63%,占出院患者的42.25%(χ2=9.09,P=0.003)。20～29分者占死亡患者的26.83%,占出院患者的8.45%(χ2=6.819,P=0.009)。ChildA级占死亡患者的21.95%,占出院患者的56.34%(χ2=12.488,P=0.000)。ChildC级占死亡患者的29.27%,占出院患者的5.63%(χ2=11.857,P=0.001)。结论死亡与存活患者MELD与Child-Pugh评分显著不同。低MELD评分患者预后好于高MELD评分者。ChildA级患者预后优于ChildC级者。MELD评分可对失代偿期肝硬化患者病情严重程度及预后作出判断。更多还原

【Abstract】 Objective To investigate MELD and Child-Pugh in the patients with decompensated liver cirrhosis.Methods 41 cases of death and 71 survivors were graded with MELD and Child-Pugh and compared.Results The deaths’ MELD and Child-Pugh score was (17.93±8.22 )and (10.07±1.84),the survivors’ was (11.18±6.54 ) and (8.04±2.09)(P=0.000).Among the deaths and survivors,MELD≤9 was 14.63% and 42.25%(P =0.003),MELD 20-29 was 26.83% and 8.45%(P=0.009),Child A was 21.95% and 56.34%(P=0.000),Child C was 29.27% and 5.63%(P=0.001).Conclusion The deaths’ MELD and Child-Pugh score is higher than the survivors’.The MELD score can act as a disease severity and prognosis index for patients with decompensated liver cirrhosis.更多还原