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低高密度脂蛋白胆固醇水平与乙型肝炎相关失代偿性肝硬化患者不良预后的关系。

Association of Low High-Density Lipoprotein Cholesterol Levels with Poor Outcomes in Hepatitis B-Associated Decompensated Cirrhosis Patients.

机构信息

Department of Clinical Laboratory, Shengzhou People's Hospital, Shengzhou Branch of the First Affiliated Hospital of Zhejiang University, Shengzhou, Zhejiang Province, China 312400.

出版信息

Biomed Res Int. 2021 Jul 27;2021:9927330. doi: 10.1155/2021/9927330. eCollection 2021.

Abstract

BACKGROUND

Lipid levels become decreased in cirrhotic patients and are correlated with disease severity. In the present study, we investigated the impact of serum high-density lipoprotein cholesterol (HDL-C) on prognosis in patients with HBV-associated decompensated cirrhosis (HBV-DeCi).

METHODS

The medical records of 153 HBV-DeCi patients were analyzed. Patients were separated into survivors and nonsurvivors according to their 30-day survival. Univariate and multivariate analyses were performed to identify predictors of poor outcomes, and the performance of these predictors was evaluated by receiver operating characteristic (ROC) curve analysis.

RESULTS

The 30-day mortality in the cohort was 18.9%. HDL-C levels differed markedly between survivors and nonsurvivors. On multivariate analysis, Model for End-stage Liver Disease (MELD) score and HDL-C level were identified as independent risk factors for mortality in HBV-DeCi patients. In the ROC analyses, the prognostic accuracy for mortality was similar between HDL-C (area under ROC curve: 0.785) and MELD score (area under ROC curve: 0.853).

CONCLUSIONS

Low HDL-C level had a significant correlation with mortality in HBV-DeCi patients and can be used as a simple marker for risk assessment and selection of therapeutic options.

摘要

背景

肝硬化患者的血脂水平降低,且与疾病严重程度相关。本研究旨在探讨血清高密度脂蛋白胆固醇(HDL-C)对乙型肝炎相关失代偿性肝硬化(HBV-DeCi)患者预后的影响。

方法

分析了 153 例 HBV-DeCi 患者的病历。根据 30 天的生存情况,将患者分为幸存者和非幸存者。通过单因素和多因素分析确定不良预后的预测因素,并通过接收者操作特征(ROC)曲线分析评估这些预测因素的性能。

结果

该队列的 30 天死亡率为 18.9%。幸存者和非幸存者的 HDL-C 水平差异明显。多因素分析显示,终末期肝病模型评分(MELD)和 HDL-C 水平是 HBV-DeCi 患者死亡的独立危险因素。在 ROC 分析中,HDL-C(ROC 曲线下面积:0.785)和 MELD 评分(ROC 曲线下面积:0.853)对死亡率的预后准确性相似。

结论

低 HDL-C 水平与 HBV-DeCi 患者的死亡率显著相关,可作为风险评估和治疗方案选择的简单标志物。

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