血清铁蛋白对失代偿期肝硬化患者死亡风险的预后价值有限：一项倾向评分匹配分析
Serum Ferritin Has Limited Prognostic Value on Mortality Risk in Patients with Decompensated Cirrhosis: A Propensity Score Matching Analysis.
作者信息
Guo Gaoyue, Sun Mingyu, Li Yifan, Yang Wanting, Wang Xiaoyu, Yu Zihan, Li Chaoqun, Hui Yangyang, Fan Xiaofei, Jiang Kui, Sun Chao
机构信息
Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.
Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China.
出版信息
Lab Med. 2023 Jan 5;54(1):47-55. doi: 10.1093/labmed/lmac064.
OBJECTIVE
The prognostic value of serum ferritin remains elusive in the literature. We aimed to examine the association between serum ferritin and mortality risk in cirrhosis.
METHODS
A total of 257 cirrhotic patients were recruited. The cut-off of serum ferritin was determined by X-tile. The Cox regression and Kaplan-Meier method were used. A 1:1 propensity score matching (PSM) was performed to diminish the impacts of selection bias and possible confounders.
RESULTS
The difference regarding mortality was mostly significant for serum ferritin >158 ng/mL. Before PSM, serum ferritin >158 ng/mL was an independent predictor of mortality. However, the clinical relevance of high ferritin level for prognostication was blunted after PSM (survival rate: 86.8% vs 96.3%, P = .078). Cox regression indicated that model for end-stage liver disease remains only independent risk factor of 180-day mortality after PSM.
CONCLUSION
Serum ferritin may not serve as an independent prognostic indicator of mortality risk in decompensated cirrhotic patients.
目的
血清铁蛋白的预后价值在文献中仍不明确。我们旨在研究血清铁蛋白与肝硬化患者死亡风险之间的关联。
方法
共招募了257例肝硬化患者。血清铁蛋白的临界值通过X-tile软件确定。采用Cox回归和Kaplan-Meier方法。进行1:1倾向评分匹配（PSM）以减少选择偏倚和可能的混杂因素的影响。
结果
血清铁蛋白>158 ng/mL时，死亡率差异最为显著。在PSM之前，血清铁蛋白>158 ng/mL是死亡率的独立预测因素。然而，PSM后高铁蛋白水平对预后的临床相关性减弱（生存率：86.8%对96.3%，P = 0.078）。Cox回归表明，终末期肝病模型仍是PSM后180天死亡率的唯一独立危险因素。
结论
血清铁蛋白可能不是失代偿期肝硬化患者死亡风险的独立预后指标。
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