病毒性肝炎肝衰竭死亡患者的临床特征分析  

Clinical features analysis of death cases of hepatic failure induced by viral hepatitis

作　　者：石小枫[1] 徐宁[1] 张丽旦[1] 郭树华[1] 刘杞[1] 任红[1] 

机构地区：[1]重庆医科大学附属第二医院感染科重庆医科大学病毒性肝炎研究所国家教育部分子生物学重点实验室,重庆400010

出　　处：《重庆医科大学学报》2008年第11期1291-1295,共5页Journal of Chongqing Medical University

基　　金：国家自然科学基金资助(30671867)

摘　　要：目的:分析病毒性肝炎所致肝衰竭死亡患者的原因,以期对临床治疗有一定的指导作用。方法:采用回顾性分析方法,收集我科5年的病毒性肝炎肝衰竭住院死亡病例115例,摘录每例病例的临床和实验室检查数据,临床和实验室检查数据的采集选用明确诊断时的检查和死亡前的最后1次检查作为研究资料。结果:年龄平均45.7岁,男性103例;慢性重型肝炎89例;肝硬化20例;114例乙肝标志物阳性,其中12例重叠其它嗜肝病毒感染;110例病例中,HBeAg阳性有24例(24/110,21.8%),HBeAb阳性有61例(61/110,55.5%);85例病例中,HBVDNA定量>1×105copies/ml者有68例(68/85,80%),HBVDNA定量<1×105copies/ml者有17例(17/85,20%);入院时TBil、PTA、ALT分别为403.17±219.43、38.33±19.14、496.78±801.56;死亡时TBil、PTA、ALT分别为478.03±234.89、32.39±16.54、218.04±426.58。出现严重的并发症。结论:病毒性肝炎肝衰竭病人主要以慢性重型肝炎和肝硬化为主,HBVDNA的活跃复制及病毒的变异对病情的发展有一定的影响,应积极寻求早期的抗病毒治疗;并发症发生率高,应积极控制并发症的发生,有利于病情的转归。Objective：To analyze the cause of patients with hepatic failure induced by viral hepatitis to provide guidance for the clinical treatment. Methods：Retrospective analysis was adopted to study the clinical data of 115 patients died of hepatic failure induced by viral hepatitis enrolled in our department for five years.The data of each case was collected from the check of final diagnosis and the last check before death. Results：Of all 115 patients,103 cases were male,12 cases were female. with an average age of 45.7 years.There were 89 cases with chronic severe hepatitis,20 cases with cirrhosis.114 cases infected hepatitic B virus including 12 cases with superfection of HAV,HDV,HEV.Of 110 cases,24 were HBeAg positive24/ 110,21.8%）, 61 were HBeAb positive（61/110,55.5%）. Of 85 cases,HBV DNA quantity of 68 cases was more than 1×10^5 copies/ml（68/85,80%）,HBV DNA quantity of 17 cases was less than 1×10^5（17/85,20%）.TBil,PTA and ALT at admission were 403.17 ±219.43,38.33 ±19.14 and 496.78 ±801.56 respectives,while those at death were 478.03±234.89,32.39 ± 16.54,218.04±426.58 respectively.Severe complications presented. Conclusion：In our country, hepatic failure was mainly induced by chronic severe hepatitis and cirrhosis infected with hepatitis B virus. The active replication of HBV DNA and the viral mutation could be causes of the development of disease. As the incidence rate of complications is high ,preventing complication is necessary to reduce fatality rate of the patients with hepatic failure.

关 键 词：病毒性肝炎 肝衰竭 死亡病例 

分 类 号：R512.6[医药卫生—内科学]