血清前白蛋白/总胆红素比值对肝衰竭患者预后的预测价值

Prognostic value of serum prealbumin/total bilirubin ratio in patients with liver failure

摘要:

目的探讨血清前白蛋白/总胆红素比值对肝衰竭患者预后的预测价值。方法回顾性分析2008年1 月-2015 年12 月该院收治的肝衰竭患者152 例相关临床数据。Log-Rank 检验与生存有关的变量进行单因素分析，Cox 回归行多因素分析。结果单因素分析显示，总胆红素（P =0.045）、前白蛋白/ 总胆红素比值（P =0.000）和肝性脑病（P =0.026）为肝衰竭患者预后的影响因素。多因素Cox 回归分析提示肝性脑病[HR=1.218，（95%CI：1.021，1.434）P =0.041]和前白蛋白/ 总胆红素比值[HR=0.712，（95%CI：0.609，0.853）P =0.000]是肝衰竭患者的独立预后因素。前白蛋白/ 总胆红素比值>17.2 的患者预后好于前白蛋白/ 总胆红素比值≤17.2 的患者（P =0.000）。结论血清前白蛋白/总胆红素比值是肝衰竭患者的独立预后因素，对肝衰竭患者的预后预测具有良好的临床判断价值，值得临床进一步推广应用。

Abstract:

Objective To explore the prognostic value of prealbumin/total bilirubin ratio in patients with liver failure. Methods The clinical data of 152 patients with liver failure in our hospital from January 2008 to December 2015 were retrospectively analyzed. Log -Rank test was used for calculating survival related variable and univariate analysis, and Cox regression was used for calculating HR and multivariate analysis. Results Results of univariate analysis showed that total bilirubin (P = 0.045), prealbumin/total bilirubin ratio(P = 0.000) and hepatic encephalopathy (P = 0.026) were prognostic factors for patients with liver failure.Results of multivariate Cox regression analysis demonstrated that hepatic encephalopathy (HR = 1.218; 95%CI:1.021, 1.434;P = 0.041) and the prealbumin/total bilirubin ratio (HR = 0.712; 95%CI: 0.609, 0.853;P = 0.000) were independent prognostic factors in patients with liver failure. The prognosis of patients with prealbumin/total bilirubin ratio >17.2 was significantly better than that of prealbumin/total bilirubin≤17.2 (P = 0.000). Conclusions The serum prealbumin/total bilirubin ratio is an independent prognostic factor for patients with liver failure and it is valuable in prediction of prognosis in patients with liver failure, which is worth further clinical application.