COMPENSATED CIRRHOSIS - NATURAL-HISTORY AND PROGNOSTIC FACTORS
COMPENSATED CIRRHOSIS - NATURAL-HISTORY AND PROGNOSTIC FACTORS
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DOI：
10.1002/hep.1840070124
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发表时间：
1987-01-01
期刊：
影响因子：
13.5
通讯作者：
ROZMAN, C
中科院分区：
文献类型：
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作者：
GINES, P;QUINTERO, E;ROZMAN, C
为了研究代偿性肝硬化的自然史，研究了293例既往无严重并发症（腹水、黄疸、脑病或消化道出血）的连续患者的发病率（随访期间发生失代偿性肝硬化的概率）和生存率。患者在1968年至1980年间通过肝组织学诊断。中位随访时间为63个月。肝硬化失代偿被认为是当一个病人首先发展的主要并发症之一的疾病。诊断后10年，发展为失代偿性肝硬化的概率和生存概率分别为58%和47%。使用在诊断时获得的临床、生物化学和组织学数据的多变量存活分析（Cox回归模型）揭示了预测预后的七个因素：血清胆红素;血清γ-氨基丁酸;球蛋白浓度;肝斑;凝血酶原时间;性别;年龄和碱性磷酸酶。根据这些因素中的每一个对最终模型的贡献，构建了一个预后指数，可以计算估计的生存概率。通过裂样检验技术验证了该指标的预测价值。
To investigate the natural history of compensated cirrhosis, 293 consecutive patients without previous major complications (ascites, jaundice, encephalopathy or gastrointestinal hemorrhage) were studied in terms of morbidity (probability of developing decompensated cirrhosis during follow-up) and survival. Patients were diagnosed by liver histology between 1968 and 1980. Median follow-up was 63 months. Decompensation of cirrhosis was considered when a patient first developed one of the major complications of the disease. Ten years after diagnosis, the probability of developing decompensated cirrhosis and the survival probability rate were 58 and 47%, respectively. A multivariate survival analysis (Cox''s regression model) using clinical, biochemical and histological data obtained at diagnosis disclosed seven factors that predicted prognosis: serum bilirubin; serum .gamma.-globulin concentration; heaptic stigmata; prothrombin time; sex; age, and alkaline phosphatase. According to the contribution of each one of these factors to the final model, a prognostic index was constructed that allows calculation of the estimated survival probability. The predicting value of this index was validated by a split sample testing technique.