血清甲胎蛋白水平对乙肝相关慢加急性肝衰竭患者短期预后的评判作用分析

doi:10.3969/j.issn.1006-3110.2017.07.033

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摘要目的研究血清甲胎蛋白(serum alpha-fetoproteins,AFP)与终末期肝病模型(model for end-stage liver disease,MELD)评分的相关性及其在乙肝相关慢加急性肝衰竭患者预后评判中的作用。方法选取乙肝相关慢加急性肝衰竭患者80例,检测其血清AFP并进行MELD评分,分层比较两者与病死率的关系及其相关性。结果 MELD评分与病死率之间呈正相关性(r=0.939,P=0.006);血清AFP与MELD评分之间呈负相关性(r=-0.261,P=0.038);血清AFP与病死率之间呈负相关性(r=-0.983,P=0.003);MELD＜20分和20分≤MELD＜30分的患者血清AFP水平明显高于30分≤MELD＜40分和MELD≥40分的患者,差异均有统计学意义(P＜0.05)。结论血清AFP对评判乙肝相关慢加急性肝衰竭患者的病情严重程度和预后具有一定的临床参考价值。

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	张磐
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关键词 ：甲胎蛋白, MELD评分, 乙肝相关慢加急性肝衰竭, 预后

Abstract：Objective To explore the correlation between serum alpha-fetoprotein (AFP) and the model for end-stage liver disease (MELD) scoring system, and to study whether serum AFP can be used clinically as a sensitive and valuable biomarker predicting the short-term prognosis of hepatitis B virus associated acute-on-chronic liver failure (HBV-ACLF). Methods Eighty patients with HBV-ACLFwere enrolled in this study. Serum AFP was detected, and MELD scores were evaluated. All the patients were divided into four groups according to their AFP levels and MELD scores, and then the relationship was analyzed between MELD scores and the fatality rate, between serum AFP and the fatality rate as well as between MELD scores and serum AFP accordingly. Results MELD scores were positively correlated with the fatality rate(r=0.939,P=0.006). Serum AFP was negatively correlated with MELD scores (r=-0.261,P=0.038)as well as with the fatality rate(r=-0.983,P=0.003). Serum AFP levels of patients with MELD scores <20 or between 20 and 30 were significantly higher than those with MELD scores between 30 and 40 or ≥ 40, and the differences were statistically significant (P<0.05).Conclusion Serum AFP may be a clinical referential biomarker for predicting the severity and short-term prognosis of the patients withHBV-ACLF.

Key words： AFP MELD score hepatitis B virus associated acute-on-chronic liver failure prognosis

收稿日期: 2016-12-12

R512.6+2

基金资助:湖南省自然科学基金(14JJ3043);中南大学大学生自由探索项目(ZY2015799)

作者简介: 张磐(1974-),女,博士,副主任医师,研究方向:病毒性肝炎及肝纤维化。

引用本文:

张磐, 杨爽, 周彧来. 血清甲胎蛋白水平对乙肝相关慢加急性肝衰竭患者短期预后的评判作用分析[J]. 实用预防医学, 2017, 24(7): 875-878. ZHANG Pan, YANG Shuang, ZHOU Yu-lai. Role of serum alpha-fetoprotein level in the judgement of short-term prognosesof patients with hepatitis B virus associated acute-on-chronic liver failure. , 2017, 24(7): 875-878.

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https://www.syyfyx.com/CN/10.3969/j.issn.1006-3110.2017.07.033 或 https://www.syyfyx.com/CN/Y2017/V24/I7/875

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