Giá trị của thang điểm Child Pugh, MELD và MELDNa trong tiên lượng tử vong ở bệnh nhân xơ gan mất bù do viêm gan virus B

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Văn Tuấn Nguyễn, Thị Diệu Ngân Tạ

Ngôn ngữ: vie

Ký hiệu phân loại: 612.35 Biliary tract and liver

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2023

Mô tả vật lý: 361-366

Bộ sưu tập: Metadata

ID: 502468

Thêm vào giỏ

Đánh giá giá trị của thang điểm Child Pugh, MELD và MELDNa trong tiên lượng tử vong ở bệnh nhân xơ gan mất bù do virus viêm gan B, chúng tôi tiến hành nghiên cứu mô tả trên 149 bệnh nhân xơ gan mất bù do viêm gan virus B điều trị tại Bệnh viện Bệnh Nhiệt đới Trung ương từ tháng 8/2022 đến tháng 07/2023. Bệnh nhân được theo dõi và đánh giá tử vong trong vòng 90 ngày sau khi nhập viện. Kết quả nghiên cứu cho thấy, tỉ lệ tử vong là 32,2%. Nguyên nhân tử vong chủ yếu do hôn mê gan (58,3%), tiếp theo đến xuất huyết tiêu hoá (20,8%), nhiễm trùng (8,3%). Tỉ lệ xơ gan Child-Pugh B và C lần lượt là 45,6% và 47,7%
76,5% bệnh nhân có điểm MELD >
18 điểm
MELDNa 20-29 điểm và 30-39 điểm chiếm tỷ lệ lần lượt là 40,3% và 36,9%. MELDNa có giá trị tiên lượng tử vong tốt hơn so với MELD và Child Pugh với diện tích dưới đường cong là 0,732 so với 0,655 và 0,578. Điểm cắt có giá trị tiên lượng nguy cơ tử vong trong vòng 90 ngày sau nhập viện đối với thang điểm Child-Pugh là 8 điểm, thang điểm MELD là 23 điểm và MELD Na là 25, với độ nhạy/độ đặc hiệu lần lượt là 81,3%/37,6%
68,8%/49,5% và 87,5%/ 47,5%.To evaluate the prognostic value of the Child-Pugh, MELD, and MELDNa scores in patients with decompensated hepatitis B cirrhosis, we conducted a study in 149 patients with decompensated hepatitis B cirrhosis treated at the National hospital for Tropical diseases from August 2022 to July 2023. The patients were followed and mortality was evaluated within 90 days after admission. The study results showed that the mortality rates was 32.2%, respectively. The main causes of death were hepatic encephalopathy (58,3%), followed by gastrointestinal bleeding (20.8%), and infection (8.3%). The proportions of Child-Pugh class B and C were 45.6% and 47.7%, respectively
the group with MELD scores >
18 points accounted for 76.5%
the MELDNa groups with scores of 20-29 and 30-39 accounted for 40.3% and 36.9%, respectively. MELDNa had a better predictive value for mortality compared to MELD and Child-Pugh, with area under the curve (AUC) values of 0.732, 0.655, and 0.578, respectively. The optimal cutoff points for Child-Pugh, MELD, and MELDNa in predicting mortality were 8, 23, and 25, with sensitivities/specificities of 81.3%/37.6%
68.8%/49.5% and 87.5%/47.5%, respectively.

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