终末期肝病患者肝移植短期预后的多因素分析

Wei Chen, A. Gu, H. Ding, Yongxiang Yi, Guang‐shun Yang
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摘要

目的分析终末期肝病患者肝移植围手术期的多项指标,寻求能够准确预测短期(≤3个月)预后的相关因素。方法回顾性分析在同一治疗中心连续接受肝移植的终末期肝病患者的临床资料。采用Logistic回归分析受者性别、年龄、体重指数、术前血清白蛋白水平、血清钠浓度、尿素氮水平、供受体血型等围手术期指标。采用多元logistic回归分析相关因素。统计处理软件包为SAS 9.1.3软件。差异有统计学意义,P<0.05。结果165例患者中有18例在移植后3个月内死亡(死亡率10.9%)。单因素分析结果显示,术前血清钠、血尿素氮、PT-INR、CTP评分、MELD评分、MELD- na评分与早期死亡率相关,且有统计学意义。根据Logistic多元回归的结果。但只有MELD-Na评分与3个月预后相关(P=0.001, β=-2.510, OR=0.088, 95% CI=0.037~0.349)。结论术前MELD-Na评分是影响终末期肝病患者短期生存的独立危险因素。MELD-Na评分越高,早期死亡率越高。关键词:肝移植;预后;风险因素;多样性分析
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multivariate analysis of short-term prognosis of liver transplantation in patients with end-stage liver disease
Objective To analyze many indicators during perioperative period of liver transplantation in patients with end-stage liver disease, only to seek related factors that can accurately predict short-term(≤three months)outcome. Methods We analyzed retrospectively clinical data of consecutive patients with end-stage liver diseases undergone liver transplantation in a single treatment center. Logistic regression analysis was used to analyze the perioperative indicators including recipient gender, age, body mass index, preoperative serum albumin level, serum sodium concentration, urea nitrogen level and donor-recipient blood group, et al. Correlated factors were analyzed by the method of multivariate logistic regression. Statistical processing package was SAS 9.1.3 soft. The difference was statistically significant with P<0.05. Results 18/165 patients died within 3 months after transplantation(mortality rate: 10.9 %). According to the result of univariate analysis, the indicators correlated with early mortality which were statistically significant were preoperative serum sodium, blood urea nitrogen, PT-INR, CTP score, MELD score and MELD-Na score. On the base of the result of Logistic multiple regression. However, only MELD-Na score was associated with 3 months prognosis(P=0.001, β=-2.510, OR=0.088, 95 % CI=0.037~0.349). Conclusions Preoperative MELD-Na score is an independent risk factor for short-term survival in patients with end-stage liver disease. Higher MELD-Na score is, the early mortality is higher. Key words: Liver transplantation; Prognosis; Risk factor; Multiplicity analysis
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