PROGNOSTIC VALUE OF CHILD-TURCOTTE CRITERIA IN MEDICALLY TREATED CIRRHOSIS
PROGNOSTIC VALUE OF CHILD-TURCOTTE CRITERIA IN MEDICALLY TREATED CIRRHOSIS
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DOI：
10.1002/hep.1840040313
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发表时间：
1984-01-01
期刊：
影响因子：
13.5
通讯作者：
TYGSTRUP, N
中科院分区：
文献类型：
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作者：
CHRISTENSEN, E;SCHLICHTING, P;TYGSTRUP, N
Child-Turcotte 标准 (CTC)（基于血清胆红素和白蛋白、腹水、神经系统疾病和营养）是接受门静脉分流手术的肝硬化患者的既定预后因素。 CTC 的预后价值在保守治疗的肝硬化中进行了评估。研究人员对来自对照临床试验对照组的经组织学证实的肝硬化患者 (n = 245) 进行了研究。进入试验时的数据用于根据 CTC 对患者进行分类。绘制了长达 16 年的生存曲线，并使用对数秩检验比较了生存率。随着白蛋白（P < 0.001）、腹水（P < 0.001）、胆红素（P = 0.02）和营养状况（P = 0.11）异常程度（A.fwdarw.B.fwdarw.C）的增加，生存率显着下降，可能是因为在进入试验时没有患者出现肝昏迷。 CTC 中的 5 个变量合并为一个分数。随着分数的增加，中位生存时间从 6.4 年（5 分）减少到 2 个月。 （分数12或以上）。此外，肝衰竭、胃肠道出血或肝细胞癌的死亡率随着评分的增加而显着增加。 CTC 提供有价值且易于获得的肝硬化预后信息。然而，CTC 不如基于预后因素多变量分析的预后指数。
The Child-Turcotte criteria (CTC) (based on serum bilirubin and albumin, ascites, neurological disorder and nutrition) are established prognostic factors in patients with cirrhosis having portacaval shunt surgery. The prognostic value of CTC was evaluated in conservatively treated cirrhosis. Patients (n = 245) with histologically verified cirrhosis from a control group of a controlled clinical trial were studied. Data at entry into the trial were used to classify patients according to CTC. Survival curves for up to 16 yr were made, and survival rates were compared using the log-rank test. Survival decreased significantly with increasing degree of abnormality (A .fwdarw. B .fwdarw. C) of albumin (P < 0.001), ascites (P < 0.001), bilirubin (P = 0.02) and nutritional status (P = 0.11) probably because none of the patients had hepatic coma at entry into the trial. The 5 variables in CTC were combined to a score. With increasing score, the median survival time decreased from 6.4 yr (score 5) to 2 mo. (scores 12 or more). Furthermore, the mortality from hepatic failure, gastrointestinal bleeding or hepatocellular carcinoma increased significantly with increasing score. CTC provide valuable and easily obtainable prognostic information in cirrhosis. However, CTC are inferior to a prognostic index based on multivariate analysis of prognostic factors.