摘要
目的探讨甲胎蛋白(alpha fetoprotein,AFP)-HINAT模型联合评分对乙型病毒性肝炎相关慢加急性肝衰竭(hepatitis B virus-related acute-on-chronic liver failure,HBV-ACLF)患者预后的预测价值,并与其他评分模型对比。方法纳入2020年1月至2024年12月在郑州大学第二附属医院消化内科就诊的75例HBV-ACLF患者作为研究对象,按确诊后90 d的预后情况分为存活组(n=31)和死亡组(n=44)。分析HBV-ACLF患者短期预后的影响因素,并分析AFP、HINAT模型及AFP-HINAT联合评分与其他评分模型在患者短期预后预测方面的效能。结果AFP和HINAT模型是HBV-ACLF患者预后的独立危险因素(P<0.05),对比AFP、HINAT模型和其他评分模型,AFP-HINAT联合评分的预测效能更好(AUC=0.891),临床有效性更高(NRI>0,IDI>0)。结论AFP-HINAT联合评分评估HBV-ACLF患者短期预后有较高的价值和净收益。
Objective To investigate the predictive value of the alpha-fetoprotein(AFP)-HINAT model combined with other scoring models for the prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods A total of 75 HBV-ACLF patients treated in the Department of Gastroenterology,the Second Affiliated Hospital of Zhengzhou University from Jan.2020 to Dec.2024 were enrolled.Based on their 90-day prognosis after diagnosis,they were divided into a survival group(n=31)and a death group(n=44).The factors influencing short-term prognosis were analyzed,and the predictive efficacy of AFP,HINAT model,AFP-HINAT combined score,and other scoring models was evaluated.Results AFP and HINAT model were independent risk factors for HBV-ACLF prognosis(P<0.05).Compared to AFP,HINAT model and other scoring models,the AFP-HINAT combined score demonstrated superior predictive efficacy(AUC=0.891)and higher clinical validity(NRI>0,IDI>0).Conclusion The AFP-HINAT score has high predictive value and net benefit in assessing the short-term prognosis of HBV-ACLF patients.
作者
许龙星
XU Longxing(Department of Gastroenterology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《胃肠病学和肝病学杂志》
2025年第7期1032-1038,共7页
Chinese Journal of Gastroenterology and Hepatology
