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全免疫性炎症值改善了MELD 3.0对于严重病患肝硬化患者的死亡率预测

Ling Zhu¹, Peibo Li², Chengdong You³

¹Department of Cardiovascular Diseases, People's Hospital of Xiushan County, Xiushan, 409900, Chongqing, China.

Scientific reports

|December 17, 2025

概括

全免疫-炎症值 (PIV) 预测了严重患肝硬化患者的死亡率. 将PIV与MELD 3.0得分相结合,可以改善风险分层,从而做出更好的临床决策.

科学领域:

临界护理医学临界护理医学
肝病学肝病学是一种肝病学.
生物标志物研究生物标志物研究

背景情况:

肝硬化是全球主要的健康问题,死亡率高.
目前的预测工具,如MELD 3.0,在预测结果方面表现不佳.
全免疫炎症值 (PIV) 是系统性炎症的新兴生物标志物.

研究的目的:

评估PIV对严重病患肝硬化患者死亡率的预测价值.
为了评估PIV与MELD 3.0得分的协同效应.
探索PIV在增强肝硬患者风险分层中的作用.

主要方法:

来自MIMIC-IV数据库的2,399名危急性肝硬化患者的分析.
计算PIV (中性粒细胞 × 血小板 × 单细胞/淋巴细胞).
利用多变量Cox模型,受限立方线,ROC分析和校准曲线来评估PIV与28天和365天死亡率的关联.

主要成果:

较高的PIV四分位数与更老的年龄,更多的并发症和更糟糕的代谢概况有关.
PIV显示了与死亡率的J形关联,最高四分位数的死亡率显着更高.
与单个标记器相比,PIV-MELD 3.0复合模型显示出优异的预测性能.

结论:

PIV独立地预测了肝硬化患者的短期和长期死亡率.
将PIV与MELD 3.0集成,可以提高风险分层的准确性.
在肝硬化患者管理中,PIV为临床决策提供了具有成本效益的工具.

关键词:

肝硬化是肝硬化的一种疾病.在MELD 3.0中使用MELD 3.0.死亡率死亡率死亡率泛免疫性炎症的价值.预测生物标志物预测生物标志物

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