[1]黄超明,朱玲怡,黄 琦,等.白蛋白-胆红素与碱性磷酸酶联合评分预测TIPS术后肝硬化合并门脉高压的预后[J].介入放射学杂志,2025,34(06):584-589.[doi:10.3969/j.issn.1008-794X.2025.06.005]
　HUANG Chaoming,ZHU Lingyi,HUANG Qi,et al.The combination score of albumin-bilirubin index and alkaline phosphatase in predicting the prognosis of patients with cirrhosis complicated by portal hypertension after transjugular intrahepatic portosystemic shunt[J].J Intervent Med,2025,34(06):584-589.[doi:10.3969/j.issn.1008-794X.2025.06.005]
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白蛋白-胆红素与碱性磷酸酶联合评分预测TIPS术后肝硬化合并门脉高压的预后()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
34
期数:
2025年06
页码:
584-589
栏目:
血管介入
出版日期:
2025-06-25

文章信息/Info

Title:
The combination score of albumin-bilirubin index and alkaline phosphatase in predicting the prognosis of patients with cirrhosis complicated by portal hypertension after transjugular intrahepatic portosystemic shunt
文章编号:
1008-794X(2025)-006-0584-06
作者:
黄超明;  朱玲怡;  黄 琦;  朱子舰;  吴发宗;  张业馀;  蒋一逍;  郑丽云;  赵中伟;  纪建松
310053 浙江杭州 浙江中医药大学丽水研究生联合培养基地(黄超明、朱玲怡、黄 琦、朱子舰); 丽水市中心医院介入诊疗中心(吴发宗、张业馀、蒋一逍、郑丽云、赵中伟、纪建松)
Author(s):
HUANG Chaoming; ZHU Lingyi; HUANG Qi; ZHU Zijian; WU Fazong; ZHANG Yeyu; JIANG Yixiao; ZHENG Liyun; ZHAO Zhongwei; JI Jiansong.
Zhejiang Chinese Medical University Lishui Graduate Joint Training Base,Hangzhou,Zhejiang Province 310053,China
关键词:
白蛋白-胆红素指数;  碱性磷酸酶;  经颈静脉肝内门体分流术
分类号:
R654.3
DOI:
10.3969/j.issn.1008-794X.2025.06.005
文献标志码:
A
摘要:
目的 探讨白蛋白-胆红素(albumin-bilirubin index,ALBI)与碱性磷酸酶(alkaline phosphatase,ALP)联合评分对经颈静脉肝内门体分流术(TIPS)后肝硬化合并门脉高压患者预后的评估价值。方法 收集2016年1月至2024年6月在丽水市中心医院接受TIPS治疗的肝硬化合并门脉高压患者61例,根据ALBI和ALP的约登指数计算最佳截断值,并将患者分为低ALBI-低ALP(0分)组、高ALBI-高ALP(2分)组、高ALBI-低ALP或低ALBI-高ALP(1分)组,评价ALBI-ALP评分的效能,比较3组患者生存率、中位生存时间,分析影响患者生存时间的独立危险因素。结果 ALBI和ALP的最大约登指数为0.31和0.34,最佳截断值为-1.56和108.50。3组患者的MELD分数、Child-Pugh分级和丙氨酸转氨酶水平差异有统计学意义(均P<0.05)。ALBI-ALP评分的AUC为0.77(95%CI:0.66～0.89,P=0.000 2),优于MELD评分0.52(95%CI:0.37～0.67,P=0.77)和Child-Pugh 分级0.57(95%CI:0.43～0.72,P=0.34)。患者总病死率为49.18%,0分组的病死率为11.11%(2/18),明显低于1分组的59.46%(22/37)、2分组的100%(6/6),差异有统计学意义(χ2=18.20,P<0.001)。0分组中由于分析时仍有大量患者存活,无法计算中位生存时间,1分组的中位生存时间为38.00(95%CI:23.01～52.99)个月,2分组仅为1.00(95%CI:0.00～2.60)个月,差异有统计学意义(χ2=33.08,P<0.000 1)。3组患者1年生存率为100%、66%、17%,2年生存率为100%、64%、17%,3年生存率为90%、53%、0。Cox多因素回归分析显示,ALBI-ALP联合评分(HR=7.11,95%CI:2.95～17.15)是TIPS术后肝硬化合并门脉高压患者生存时间的独立危险因素。结论 ALBI-ALP评分能够有效评估TIPS术后肝硬化合并门脉高压患者的预后,是影响患者生存时间的独立危险因素。

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(收稿日期:2024-11-03)
(本文编辑:新 宇)

备注/Memo

备注/Memo:
通信作者: 纪建松 E-mail:jjstcty@wmu.edu.cn
更新日期/Last Update: 2025-06-25