慢性重型乙型肝炎晚期患者短期预后影响因素分析  

Influential Factor of Short-term Prognosis in Advanced Stage Patients with Chronic Severe Hepatitis B

作　　者：吴旭东[1] 甘建和[1] 赵卫峰[1] 江敏华[1] 罗二平[1] 

机构地区：[1]苏州大学附属第一医院感染病科,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2008年第3期433-435,共3页Suzhou University Journal of Medical Science

摘　　要：目的探讨影响慢性重型乙型肝炎(CSHB)晚期患者近期死亡的因素。方法回顾性分析45例CSHB晚期患者入院当日资料,计算MELD、CTP评分,观察30 d内生存情况,单因素及多因素Logistic回归分析入院当日变量与近期预后之间的关系。结果31例患者30 d内死亡,病死率为68.9%(31/45),死亡原因主要为肝性脑病,占71.0%(22/31),其次为多器官功能衰竭综合征,为22.6%(7/31)。单因素分析显示入院时MELD评分与总胆红素水平是近期存活的预测因素,多因素Logistic回归分析示近期生存与总胆红素、CTP及MELD评分相关。血清学e抗原阴性与阳性、性别在近期生存组与死亡组的差异有统计学意义(分别P<0.01和<0.05)。结论男性、e抗原阴性、入院时总胆红素水平、肝性脑病及肝肾综合征是CSHB晚期患者近期死亡的高危因素;入院时的MELD及CTP评分均可评估其近期预后。Objective To explore the influential factor of short-term prognosis in advanced stage patients with chronic severe hepatitis （CSH） B. Methods A retrospective chart review and statistical analysis were done on 45 patients consecutively admitted to CSHB. Results Thirty-one patients died during 30 days, mortality was 68.9%, hepatic encephalopathy （HE） was mainly cause of death （71.0%）, next was multiorgan dysfunction syndrome（22.6%）, admission MELD scores （P〈 0.05） and total bilirubin （P〈0.01） were independently associated with 30 days mortality, multiple factor Logistic regression analysis showed total bilirubin（P〈0.01）, MELD scores（P〈0.05）, and Child- Turcotte-Pugh（CTP） scores（P〈0.05） were associated with short-term mortality, e antigen and sexuality in short-term prognosis were significantly different （P〈0.05）. Conclusion High risk factor of short- term in advanced stage CSH is negative e antigen, hepatitis B, male, TBIL, HE, hepatorenal syn- drome（HRS） on admission. MELD and CTP score on admission can be used to evaluate short-term prognosis.

关 键 词：慢性乙型重型肝炎 终末期肝病模型评分 预后 

分 类 号：R512.62[医药卫生—内科学] R473.73[医药卫生—临床医学]