乙型肝炎患者并发慢加急性肝衰竭诱因及转归分析289例  

Causes and clinical outcomes of acute-on-chronic liver failure in patients with hepatitis B virus infection: an analysis of 289 cases

作　　者：赵振刚[1] 韩涛[2] 高英堂[2] 高艳颖[2] 张晔[2] 吴珍萍[2] 

机构地区：[1]天津医科大学三中心临床学院,天津市300170 [2]天津市第三中心医院天津市人工细胞重点实验室,天津市300170

出　　处：《世界华人消化杂志》2009年第31期3269-3272,共4页World Chinese Journal of Digestology

基　　金：国家重点基础研究发展规划基金资助项目(973计划);No2007CB512801;科技部科技重大专项基金资助项目;No.2008ZX10002-005;天津市科委重点攻关专项基金资助项目;No.05YFSZSF02500;天津市科委应用基础研究计划面上基金资助项目;No06YFJMJC13100~~

摘　　要：目的:探讨乙型肝炎并发慢加急性肝衰竭的诱因及其转归.方法:回顾289例乙型肝炎并发慢加急性肝衰竭患者临床资料,对其病因、转归等进行分析.结果:HBV活动及变异为乙型肝炎并发慢加急性肝衰竭最主要诱因(占50.52%),感染(非病毒性)、消化道出血、药物、腹泻、酒精、HEV分别占:24.57%、4.50%、4.15%、3.46%、2.42%、2.42%.289例患者中(年龄40-70岁之间的达80.28%)226例接受了人工肝治疗,总好转率为45.33%,死亡率为44.98%.结论:HBV活动及变异居乙型肝炎并发慢加急性肝衰竭所有诱因之首.乙型肝炎基础上的HEV、HBV活动及变异免、自身疫性肝病诱发的慢加急性肝衰竭好转率高于肝癌诱发慢加急性肝衰竭好转率.AIM： To investigate the causes and clinical outcomes of acute-on-chronic liver failure （ACLF） in patients with hepatitis B virus （HBV） infection.METHODS： The clinical data of 289 HBV infection patients with ACLF were retrospectively analyzed. RESULTS： The most common cause of ACLF in HBV infection patients was HBV infection and mutation （50.52%）. The other six predominant causes of ACLF included nonviral infections （24.57%）, bleeding （4.50%）, drug use （4.15%）, diarrhea （3.46%）, alcohol use （2.42%）, and hepatitis E virus （HEV） infection （2.42%）, respectively. Of 289 patients, 80.28% ranged in age from 40 to 70 years old. After treatment, the improvement rate was 45.33%, and the mortality rate was 44.98%. CONCLUSION： HBV infection and mutation are the most common cause of ACLF in patients with HBV infection. The improvement rates achieved in patients with ACLF induced by HBV, HEV and autoimmune hepatitis （AIH） are higher than that in patients with liver carcinoma-induced ACLF.

关 键 词：慢加急性肝衰竭 乙型肝炎 诱因 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]