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在评估肝硬化预后方面,Child-Pugh分级相对于定量肝功能试验的优越性。

Superiority of the Child-Pugh classification to quantitative liver function tests for assessing prognosis of liver cirrhosis.

作者信息

Albers I, Hartmann H, Bircher J, Creutzfeldt W

机构信息

Dept. of Internal Medicine, Georg August University of Göttingen, FRG.

出版信息

Scand J Gastroenterol. 1989 Apr;24(3):269-76. doi: 10.3109/00365528909093045.

Abstract

To evaluate the prognostic value of quantitative liver function tests in comparison with established prognostic variables, the data of 47 patients with liver cirrhosis were analysed. A total of 16 variables, comprising the galactose elimination capacity and the indocyanine green clearance, the Child-Pugh classification, and several clinical and biochemical variables were subjected to Kaplan-Meier life-table analysis and Cox proportional hazards regression analysis. As independent variables, poor prognosis was associated significantly with increasing Child-Pugh score (p less than 0.00001), whereas the galactose elimination capacity (p = 0.03) and the indocyanine green clearance (p less than 0.001) were less sensitive indicators. The regression analysis showed prognostic value in decreasing sequence for Child-Pugh classification, age, sex, history of upper GI haemorrhage, and alkaline phosphatase activity. The quantitative liver function tests evaluated in the present work have less prognostic value than routinely accessible variables.

摘要

为评估定量肝功能试验与既定预后变量相比的预后价值,对47例肝硬化患者的数据进行了分析。总共16个变量,包括半乳糖清除能力和吲哚菁绿清除率、Child-Pugh分级以及若干临床和生化变量,进行了Kaplan-Meier生存表分析和Cox比例风险回归分析。作为自变量,预后不良与Child-Pugh评分增加显著相关(p<0.00001),而半乳糖清除能力(p = 0.03)和吲哚菁绿清除率(p<0.001)是较不敏感的指标。回归分析显示,按预后价值从高到低的顺序依次为Child-Pugh分级、年龄、性别、上消化道出血史和碱性磷酸酶活性。本研究中评估的定量肝功能试验的预后价值低于常规可获得的变量。

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