慢性肝衰竭患者预后的影响因素  

Risk factors of prognosis for chronic liver failure

作　　者：高艳颖[1] 韩涛[1] 阚志超[1] 

机构地区：[1]天津市第三中心医院消化内科,天津市300170

出　　处：《世界华人消化杂志》2008年第29期3343-3346,共4页World Chinese Journal of Digestology

基　　金：天津市卫生局重点攻关资助项目;No.07KG9~~

摘　　要：目的:探讨影响慢性肝衰竭患者预后的独立危险因素,并建立预测模型.方法:选择天津市第三中心医院2002-05/2007-03行人工肝治疗的慢性肝功能衰竭,且病例资料完整的患者228例,对其临床资料进行回顾性分析.使用Logistic回归分析筛选影响预后的独立危险因素,根据筛选出的独立危险因素建立适合我国慢性肝衰竭患者的预测模型.结果:影响慢性肝衰竭患者预后的独立危险因素有Child-Pugh评分、血钠值、酪氨酸、是否有胆酶分离、是否合并肝癌、间接胆红素及白细胞.228例慢性肝衰竭患者中大于9.5分者的病死率72.18%,小于9.5分者的病死率13.68%,两组比较有显著性差异(P<0.05).患者早期的病死率为13.68%,中期的病死率68.91%,晚期的病死率为100%,三组比较有显著性差异(P<0.05).结论:本研究建立的LOG模型对慢性肝衰竭患者的预后有很好的预测性.AIM： To investigate independent risk factors of prognosis for chronic liver failure and to establish its prognostic model. METHODS： Retrospective analysis was conducted on clinical aspects of 228 patients with liver failure receiving artificial liver treatment between May 2002 and March 2007 in Tianjin third central hospital. Data were analyzed using SPSS 13.0 statistic software. Quantitative data were analyzed using t test and rank test, and qualitative data were analyzed using Chi-square test, then Logistic regression analysis was used for selecting the independent risk factors affecting the prognosis. Based on independent risk factors from Logistic regression model, prognostic model for our patients with chronic liver failure was established. RESULTS： Independent risk factors included Child-Pugh score, tyrosine, bilirubin separation ALT, liver cancer, indirect bilirubin, serum sodium and leukocyte. The mortality of patients with LOG model score higher than 9.5 was 72.18%, while the mortality of patients with LOG model score under 9.5 was 13.68%. There was significant difference between the two （P 〈 0.05）. Based on LOG model score, 7-9 score was considered as early stage, 10-12 score as middle stage and 13-14 score as advanced stage. The mortality of three stages were 13.68%, 68.91%, and 100%, respectively, which showed significant differences among them （P 〈 0.05）. CONCLUSION： Child-Pugh score, tyrosine, bilirubin separation ALT, liver cancer, indirect bilirubin, serum sodium and leukocyte are independent risk factors affecting prognosis. LOG model established in our study has better predictability.

关 键 词：慢性肝衰竭 预后的预测因子 LOGISTIC回归 LOG模型 

分 类 号：R575.3[医药卫生—消化系统] R587.1[医药卫生—内科学]