Model For End-stage Liver Disease的概述|专业知识背景|拓展阅读-小狗文献

Model For End-stage Liver Disease

消化

关键词：消化 计算模型 预测终末期肝病死亡率

词汇介绍

拓展阅读

解析

model 英 [ˈmɒdl] 美 [ˈmɑ:dl]

释义 n. 模型；典型；模范；模特儿；样式

vt. 模拟；塑造；模仿

vi. 做模型；做模特儿

adj. 模范的；作模型用的

例句 Epidemiologic and animal model studies provide evidence for this model.流行病学和动物模型研究为该模型提供了证据。

end-stage 英 [end-steɪdʒ] 美 [ɛnd-stedʒ]

释义 n. 末期

例句 The renal fibrosis is the end-result of all chronic renal disease and the primary cause of the end-stage chronic renal failure.肾脏纤维化是所有慢性肾脏疾病发展的最终结果，是导致终末期肾功能衰竭的主要原因之一。

liver 英 [ˈlɪvə(r)] 美 [ˈlɪvɚ]

释义 n. 肝脏；生活者，居民

例句 They also found particles in the liver cells of patients with hepatitis.他们在肝炎病人的肝细胞也发现了这种微粒。

disease 英 [dɪˈzi:z] 美 [dɪˈziz]

释义 n. 病，[医] 疾病；弊病

vt. 传染；使…有病

例句 Your doctor will be the one to ascertain if you do in fact have the disease.您的医生将是一个以确定如果你确实有这种疾病。

概述

终末期肝病一直以来都没有一个较完善的评分指标来评价其严重程度。自终末期肝病模型(model for end-stage liver disease，MELD)标准制定以来，因其可对终末期肝病短期、中期死亡率进行有效的预测，并因其评价指标获得简单、客观、易于计算而在肝病诊治中广为应用。由来及计算公式2000年Malinchoc等首先应用MELD来预测终末期肝病行经颈静脉肝内门-体分流术后患者的死亡率，并证实MELD可以预测终末期肝病的死亡率及术后的生存

Handgrip Strength Adds More Prognostic Value to the Model for End-Stage Liver Disease Score Than Imaging-Based Measures of Muscle Mass in Men With Cirrhosis复制标题

手握力量为终末期肝病评分模型增加了比基于成像的肝硬化男性肌肉质量测量更多的预后价值

发表时间：2019-07-08

影响因子：4.2

作者： Marie Sinclair

期刊：Liver Transplantation

Sarcopenia is associated with mortality in cirrhosis, but there is no gold standard for its diagnosis. The comparative utility of different diagnostic methods is unknown. This single-center observational cohort study followed 145 men referred for liver transplant evaluation between 2005 and 2012. Muscle mass was estimated by handgrip strength, dual energy X-ray absorptiometry (DEXA) lean mass, and single-slice computed tomography (CT) scan at the fourth lumbar vertebra. Recorded outcomes included time to death or liver transplantation. The median (interquartile range [IQR]) age was 54 years (47-59 years), and Model for End-Stage Liver Disease (MELD) score was 17 (14-23). Of 145 men, 56 died with a median (IQR) time to death of 7.44 months (3.48-14.16 months). In total, 79 men underwent transplantation with median (IQR) time to transplant of 7.20 months (3.96-12.84 months). The prevalence of sarcopenia differed between diagnostic modalities with 70.3% using CT muscle mass, 45.9% using handgrip strength, and 38.7% using DEXA. Muscle mass was inversely associated with wait-list mortality for measured CT muscle mass (hazard ratio [HR], 0.94; 95% confidence interval (CI), 0.90-0.98; P = 0.002), DEXA muscle mass (HR, 0.99; 95% CI, 0.99-0.99; P = 0.003), and handgrip strength (HR, 0.94; 95% CI, 0.91-0.98; P = 0.002). These results retained significance independent of the MELD score. In predicting mortality, the MELD-handgrip strength bivariate Cox model was superior to a MELD-CT muscle Cox model (P < 0.001). In conclusion, handgrip strength combined with MELD score was the superior predictive model in this novel study examining 3 commonly employed techniques to diagnose sarcopenia in cirrhosis. Handgrip strength has additional potential clinical benefits because it can be performed serially without the radiation dose, cost, and access issues attributable to CT and DEXA.

译文

肌肉减少症与肝硬化的死亡率有关，但其诊断没有金标准。不同诊断方法的比较效用是未知的。这项单中心观察性队列研究追踪了2005年至2012年期间转诊进行肝移植评估的145名男性。通过手握力量，双能X射线吸收测定法（DEXA）瘦体重和单层计算机断层扫描（CT）扫描评估肌肉质量。在第四腰椎。记录的结果包括死亡或肝移植的时间。中位数（四分位距[IQR]）年龄为54岁（47-59岁），终末期肝病模型（MELD）评分为17（14-23）。在145名男性中，56人死亡，中位数（IQR）死亡时间为7.44个月（3.48-14.16个月）。共有79名男性接受了移植，移植中位数（IQR）为7.20个月（3.96-12.84个月）。肌肉减少症的患病率在诊断方式上有所不同，使用CT肌肉质量为70.3％，使用手握力量为45.9％，使用DEXA为38.7％。肌肉质量与测量的CT肌肉质量的等待名单死亡率呈负相关（风险比[HR]，0.94; 95％置信区间（CI），0.90-0.98; P = 0.002），DEXA肌肉质量（HR，0.99; 95）％CI，0.99-0.99; P = 0.003），和手柄强度（HR，0.94; 95％CI，0.91-0.98; P = 0.002）。这些结果保留了与MELD评分无关的显着性。在预测死亡率时，MELD-手柄力量双变量Cox模型优于MELD-CT肌肉Cox模型（P <0.001）。总之，手握力量与MELD评分相结合是这项新研究的优秀预测模型，该研究检查了3种常用的诊断肝硬化肌肉减少症的技术。手柄强度具有额外的潜在临床益处，因为它可以连续进行而没有可归因于CT和DEXA的辐射剂量，成本和访问问题。