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修正后Chlid记分在乙型肝炎相关性疾病中预后预测研究
Objective To evaluate whether the traditional Child-Turcotte-Pugh ( CTP) can be improved by adding serum creatinine and/or serum sodium values, and to assess whether the modified CTP score can challenge the short-term prognostic ability of the MELD score. Methods 187 patients with hepatitis B related disease were studied. CTP score, Child-Pugh-Na (CTP-Na) , Child-Pugh-creatinine (CTP- Cr)score,Child-Pugh-Na-creatinine ( CTP-Na-Cr) score,model for End-Stage Liver Disease ( MELD) score and MELD the incorporation of serum sodium ( MELD-Na) score were calculated. The 3-month and 1 year mortality in the patients was measured,and the validity of each models was analyzed. Results At 3-month and 1 year enrollment, the prognostic score of survival group was significantly lower than that of death group in each prognostic score model,P <0. 05. There were no significant difference between the same group in 3- month and 1 year enrollment of each prognostic score,P>0. 05. The CTP-Na-Cr score and MELD-Na score had a significantly higher AUC in comparison with MELD, CTP-Na and CTP at 3-month enrollment (P < 0. 05)and CTP-Na-Cr score also had a significantly higher AUC in comparison with MELD,CTP-Na and CTP at 1 year enrollment. There was no significant difference between 3-month AUC data and 1 year enrollment one of each prognostic score,P >0. 05. Conclusions The CTP-Na-Cr score model is a more accuracy model than other score models,it deserve further research.