一种预测慢性乙型肝炎患者内镜治疗后静脉曲张出血长期生

StephenW

Dig Liver Dis. 2019 Jan 14. pii: S1590-8658(19)30011-8. doi: 10.1016/j.dld.2019.01.004. [Epub ahead of print]
A new algorithm for predicting long-term survival in chronic hepatitis B patients with variceal bleeding after endoscopic therapy.
He L1, Li P1, Jiang Y1, Hu J1, Ma J1, Ye X1, Yang J1, Zhou Y1, Liang X1, Ai Z1, Lin Y1, Wei H2.
Author information

1
    Department of gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
2
    Department of gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, China. Electronic address: [email protected].

Abstract
BACKGROUND AND AIMS:

A predictive algorithm for survival is urgently needed in clinical practice. This study aimed to establish an algorithm to predict long-term survival in chronic hepatitis B (CHB) patients with hepatic cirrhosis and variceal bleeding after endoscopic therapy.
METHODS:

This was a retrospective study in which 603 patients who followed-up for three years were randomly assigned into a training cohort and a validation cohort in a 2:1 ratio. A new score model was devised based on the result of Cox regression analysis in the training cohort, and was verified in the validation cohort.
RESULTS:

A prediction score model composed of age, neutrophil-lymphocyte ratio, gamma-glutamyl transpeptidase and MELD score was established. The score ranged from 0 to 11. Areas under the ROC curve of the score were 0.821 (p < 0.001, 95% CI: 0.769-0.873) and 0.827 (p < 0.001, 95% CI: 0.753-0.900) in the training cohort and validation cohort, respectively. Scores 0-4 and 5-11 identified patients as low-risk and high-risk categories, respectively. The cumulative 3-year survival rate was significantly higher in the low-risk group than in the high-risk group (p < 0.001).
CONCLUSION:

The new score model can be used to predict long-term survival in CHB patients with hepatic cirrhosis and variceal bleeding after endoscopic therapy.

Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
KEYWORDS:

Endotherapy; Gastroesophageal varices; Hepatitis B; Score model; Survival

PMID:
    30723020
DOI:
    10.1016/j.dld.2019.01.004

StephenW

Dig Liver Dis。 2019年1月14日.pii：S1590-8658（19）30011-8。 doi：10.1016 / j.dld.2019.01.004。 [印刷前的电子版]
一种预测慢性乙型肝炎患者内镜治疗后静脉曲张出血长期生存的新算法。
He L1，Li P1，Jiang Y1，Hu J1，Ma J1，Ye X1，Yang J1，Zhou Y1，Liang X1，Ai Z1，Lin Y1，Wei H2。
作者信息

1
    首都医科大学附属北京地坛医院消化内科，北京
2
    首都医科大学附属北京地坛医院消化内科，北京电子地址：[email protected]。

抽象
背景和目的：

临床实践中迫切需要一种生存预测算法。本研究旨在建立一种预测内镜治疗后慢性乙型肝炎（CHB）肝硬化和静脉曲张出血患者长期生存的算法。
方法：

这是一项回顾性研究，其中603名随访3年的患者被随机分配到训练组和验证组中，比例为2：1。基于训练群组中Cox回归分析的结果设计了新的评分模型，并在验证队列中进行了验证。
结果：

建立了由年龄，中性粒细胞 - 淋巴细胞比率，γ-谷氨酰转肽酶和MELD评分组成的预测评分模型。评分范围为0至11.评分的ROC曲线下面积为0.821（p <0.001,95％CI：0.769-0.873）和训练组中的0.827（p <0.001,95％CI：0.753-0.900）和验证队列。分数0-4和5-11分别将患者确定为低风险和高风险类别。低风险组的累积3年生存率显着高于高风险组（p <0.001）。
结论：

新的评分模型可用于预测内镜治疗后肝硬化和静脉曲张出血的CHB患者的长期存活率。

版权所有©2019 Editrice Gastroenterologica Italiana S.r.l.由Elsevier Ltd.出版。保留所有权利。
关键词：

Endotherapy;胃食管静脉曲张;乙型肝炎;分数模型;生存

结论：
    30723020
DOI：
    10.1016 / j.dld.2019.01.004