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血清胆固醇是肝硬化患者死亡率的重要且独立的预测因子。

Serum cholesterol is a significant and independent mortality predictor in liver cirrhosis patients.

机构信息

1st Department of Internal Medicine, Pavol Jozef Šafárik University Kosice, Trieda SNP 1, Košice, Slovakia, 04001.

出版信息

Ann Hepatol. 2013 Jul-Aug;12(4):581-7.

Abstract

BACKGROUND AND AIM

Accurate assessment of cirrhotic patient's prognosis is essential for decisions regarding the course of treatment. Therefore we aimed to confirm and quantify the predictive value of serum cholesterol and serum triglycerides in liver cirrhosis patients.

MATERIAL AND METHODS

We performed a retrospective observational cohort study on consecutive patients with liver cirrhosis (n = 191). Relevant clinical and laboratory variables were obtained from patients' charts and patients were followed for two months. Mortality was the main outcome.

RESULTS

Thirty-eight patients died in the follow-up period. Significant difference was observed in the level of total serum cholesterol between surviving and deceased patients (2.27 ± 1.02 mmol/L vs. 2.97 ± 1.00 mmol/L, P < 0.0001 respectively). Cholesterol was confirmed as a significant predictor of mortality in univariate logistic regression analysis, and independent predictor beside bilirubin, creatinine and MELD score in multivariate logistic regression analysis. Addition of serum cholesterol level to a prognostic model based on total bilirubin, creatinine and INR increased its accuracy by 4%. Adding cholesterol to the MELD score improved prediction accuracy by 3%. There was no significant difference in serum levels of triglycerides between surviving and deceased patients.

CONCLUSION

Serum cholesterol is a routinely measured parameter, which has independent prognostic value in patients with liver cirrhosis.

摘要

背景与目的

准确评估肝硬化患者的预后对于治疗方案的决策至关重要。因此,我们旨在证实并量化血清胆固醇和血清三酰甘油在肝硬化患者中的预测价值。

材料与方法

我们对连续的肝硬化患者(n = 191)进行了回顾性观察性队列研究。从患者的病历中获得了相关的临床和实验室变量,并对患者进行了两个月的随访。死亡率是主要结局。

结果

在随访期间,38 名患者死亡。存活患者和死亡患者的总血清胆固醇水平存在显著差异(2.27 ± 1.02 mmol/L 与 2.97 ± 1.00 mmol/L,P < 0.0001)。在单因素逻辑回归分析中,胆固醇被证实是死亡率的显著预测因子,而在多因素逻辑回归分析中,除胆红素、肌酐和 MELD 评分外,胆固醇也是独立的预测因子。在基于总胆红素、肌酐和 INR 的预后模型中加入血清胆固醇水平可将其准确性提高 4%。将胆固醇加入 MELD 评分可提高预测准确性 3%。存活患者和死亡患者的血清三酰甘油水平无显著差异。

结论

血清胆固醇是一个常规测量的参数,它在肝硬化患者中有独立的预后价值。

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