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儿科急性肝衰竭的预后标志物

Andreia Filipa Nogueira¹, Catarina Teixeira¹, Carla Fernandes¹

¹Pediatric Intensive Care Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

GE Portuguese journal of gastroenterology

|May 17, 2024

概括

入院时的乳酸盐水平可以预测儿科急性肝衰竭 (PALF) 的结果,提供一种简单但有效的预后工具. 这一发现有助于管理PALF患者并优化器官分配决策.

科学领域:

儿科重症监护医药儿科重症监护医药
肝病学肝病学是一种肝病学.
生物标志物研究的研究.

背景情况:

儿科急性肝衰竭 (PALF) 是一种罕见但严重的疾病,死亡率高.
准确的预后标记对于优化器官分配和患者管理至关重要.
现有的预后得分需要在不同儿科群体中进行验证.

研究的目的:

评估各种生物标志物和预后得分在预测儿科急性肝衰竭 (PALF) 结果中的准确性.
确定可靠的预测器自发恢复与需要肝移植或死亡.

主要方法:

在28年时间内,对在儿科重症监护室 (PICU) 住院的PALF患者进行了回顾性观察性研究.
患者被分为自发恢复 (SR) 和非自发恢复 (NSR) 组.
分析包括乳酸,氨,INR水平和预后得分 (LIU,PRISM,PALF-ds) 进行预测准确性.

主要成果:

吸收时的乳酸 (AUC 0.72),的峰值 (AUC 0.72),和INR的峰值 (AUC 0.70) 在预测非自发恢复 (NSR) 中显示了可接受的准确性.
乳酸在入院时被确定为NSR的独立预测因子.
LIU (AUC 0.73) 和PRISM (AUC 0.71) 的分数显示了可接受的歧视,而PALF的三角分数 (PALF-ds) 显示了更低的容量 (AUC 0.63).

结论:

住院时的乳酸盐水平是一个有价值且易于获得的生物标志物,用于预测儿科急性肝衰竭 (PALF) 的结果.
摄入乳酸的预后性能与LIU和PRISM等更复杂的得分相当.
动态PALF-ds得分在这个队列中显示出比预期的更低的预测值.

关键词:

严重的肝衰竭是急性肝衰竭.乳酸盐是一种乳酸盐.肝脏移植是什么?肝移植是什么?儿科急性肝功能衰竭儿科急性肝功能衰竭预测预后预测预测

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