肝硬化患者发生肝肾综合征的危险因素分析及其临床意义  

Analysis of Prognostic Factors of Patients and its Clinical Significance with Chronic Severe Cirrhosis of Livers

作　　者：杜爱民[1] 夏景林 程传苗[3] 

机构地区：[1]中国人民解放军八五医院消化科,上海200052 [2]上海中山医院肝内科 [3]上海第二军医大学统计学教研室

出　　处：《临床消化病杂志》2006年第4期226-228,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的研究影响肝硬化失代偿期并发肝肾综合征(HS)的几种可能的危险因素。方法2003年1月至2005年1月住院确诊为病毒性肝炎后肝硬化失代偿期患者86例。分析患者的3项生化指标:血钠、血CA50、血CA125及其随访资料。用COX比例风险模型进行单因素和多因素分析。结果(1)轻度、中度、重度低血钠症肝硬化患者的HS发生的中位时间分别为32d、24d、10d;(2)16例血CA50、血CA125升高的肝硬化患者的HS发生的中位时间为13d;(3)COX风险回归分析显示:低血钠症、血CA50、血CA125是肝硬化患者发生HS的独立的影响预后的重要因素。结论定时监测血钠、CA50、CA125是临床上评估肝硬化失代偿患者预后、指导治疗以及提前干预HS发生的一种简易而有效的方法。Objective To analyze prognostic factors of patiants and its clinical significance with chronic severe cirrhosis of livers. Methods From January 2003 to January 2005,86 in-patients being treated for chronic severe cirrhosis of livers were evaluated. The main clinical and laboratory variables in elude blood Na^＋ ,CA50 .CA125 were analyzed as predictive factors of risk with Cox univariate and mutivariate regression. Results （ 1 ） The median HS happening time of diffferent lower Na ＋ were 32,24,10 days; （2） The median HS happening time of 18 patients with high blood CA50, CA125 was 13 days; （3）The three prognostic factors of NA^＋, CA50, CA125 were extracted using Cox＇s proportional hazard model. The model can accurately predicted the HS happening time in an independent series of patients with chronic severe cirrhosis of livers. Conclusion The testing of blood Na^＋ ,CA50,CA125 in time is valuable in prognostic evaluation of chronic severe cirrhosis of liver and it may be useful to guide clinicians in selecting treatment methods for cirrhosis of liver.

关 键 词：肝硬化 肝肾综合征 COX MELD风险回归分析 

分 类 号：R575.2[医药卫生—消化系统]