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1、13年1月第7卷第2期ChinJClinicians(ElectronicEdition)。January15.2013.V01.7.N0.2·臨床論著·ROC曲線評價(jià)AFP在急性肝衰竭預(yù)后中的應(yīng)用李雷林芳孫李建黃輝煌許彪張軍昌李克【摘要】目的研究AFP定量對急性肝衰竭預(yù)后的判斷價(jià)值。方法2009年1月至2012年1月連續(xù)收集在解放軍第302醫(yī)院住院的71例急性肝衰竭患者。所有患者均行AFP定量檢測,并隨訪3個(gè)月。根據(jù)實(shí)際預(yù)后將患者分為生存組(n=21)及死亡組(n=50)。采用獨(dú)立變量的非參數(shù)檢驗(yàn)比較生存組和死亡組AFP水
2、平;利用ROC曲線分析AFP水平在評價(jià)急性肝衰竭患者預(yù)后中的作用,并結(jié)合臨界值進(jìn)行四格表分析。結(jié)果生存組患者AFP水平(186g/L)明顯高于死亡組(36.5g/L,P=0.oo4)。通過ROC分析顯示,以121It,s/L作為急性肝衰竭預(yù)后好轉(zhuǎn)判斷的臨界值時(shí),其曲線下面積(AUC)達(dá)到0.719,靈敏度和特異度分別為0.714和0.700,對預(yù)后判斷的準(zhǔn)確率為0.714,陽性預(yù)測值為50%,陰性預(yù)測值為85.4%。結(jié)論AFP水平121g/L是急性肝衰竭患者預(yù)后判斷的臨界值,其靈敏度和特異度、準(zhǔn)確率較好,陰性預(yù)測值較高?!娟P(guān)
3、鍵詞】肝功能衰竭,急性;甲胎蛋白類;預(yù)后;ROC曲線AssessthevalueoftheAFPlevelfortheprognosisofacuteliverfailurediseasetllROCcurve/2Lei.LINFang.sUNLi-jian。HUANGHui-huang,XUBiao,ZHANGJun-chang,nICe.TheIntensiveCareCenterofThe302MilitaryHospital,Belling100039,ChinaCorrespondingauthor:LIKe,Em
4、ail:~li2004@gmail.com【Abstract】ObjectiveToassessthevalueoftheAFP(thealphafetoprotein)levelfortheprognosisofacuteliverfailuredisease.Methods71patientswithacuteliverfailurewereinvestigatedfrom302MilitaryHospitalduringJan2009toJan2012.AFPlevelinserumwasdetected.Allthe
5、patientswerefollowedfor3montlls.Thepatientsweredividedintosurvivorgroup(n=21)andnon·survivorgroup(/7,=50)accordingtotheoutcome.AFPlevelWaScomparedbetweensurvivorgroupandnon-survivorusingindependentvariablenon-parametertestandtheroleofAFPlevelintheprognosisoftheALFp
6、atientswereanalyzedbythereceiveroperatingcharacteristiccurve(ROCcurve)andthefourfoldtable.ResultsAFPlevelinsurvivorgroup(186g/L)wasmuchhierthannon-survivor(36.5g/L,P=0.004).ThecutofvalueoftheAFPlevelevaluatedbyROCcurvewas121g/L.111eareaundercurve(AUC)Was0.719withth
7、esensibility0.714andspecificity0.700,andtheaccuracyforprognosisWas0.714tIlthenegativepredictivevalue85.4%.thepositivepredictivevalue50%.CondusiomThecutofvalueoftheAFPlevelfortheprognosisofacuteliverfaihrediseaseWas12tg/L,with8bettersensibility,specificity,diagnosis
8、accuracy,andahighernegativepredictivevalue.【Keywords】Liverfailure,acute;alpha-fetoproteins;Prognosis;ROCcurve急性肝衰竭(acuteliverfailure)表示的是一種綜合預(yù)測指標(biāo)