Pugh の分類(Child変法)による肝硬変の予後に関する臨床的検討

概要

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The purpose of this study was to evaluate the prognosis value of Pugh's score, modification of the Child-Turcotte classification (CTC), in patients (pts.) with liver cirrhosis. We investigated Pugh's score, CTC, and Fisher's ratio (MR) in the clinical course of 225 pts. with liver cirrhosis. Using CTC, 39% of the pts. showed grade C at the time of one year before death. However, certain numbers of pts. showed grade C from more than 5 years before death. MR of those pts. declined gradually up to 3.5 years before death, but after that, showed no decrease until death. Therefore, it was suggested that CTC and MR were not adequete tools to estimate the precise prognosis of liver cirrhosis cases.<BR>On the other hand, Pugh's score of those pts. remained low points such as 5 to 6 until one year before death, and after that, increased remarkably until the time of death. The one year mortality of the pts. who showed more than 9 points in Pugh's score was approximately 90%. It was concluded that among Pugh's score, CTC and MR, Pugh's score was the most useful to estimate the prognosis of the pts. with liver cirrhosis especially to know whether they would die within one year or not.
社団法人日本肝臓学会の論文