严重感染与慢性重型病毒性肝炎预后关系分析  

Relationship analysis between serious infection and prognosis in patients with chronic severe viral hepatitis

作　　者：张宇锋[1] 朱翔[1] 莫志硕[1] 

机构地区：[1]中山大学附属第三医院,广州510630

出　　处：《中国医疗前沿》2010年第19期5-6,共2页China Healthcare Innovation

基　　金：国家十一五科技重大专项课题(编号:2008ZX10002-007)

摘　　要：目的探讨慢性重型病毒性肝炎患者严重感染与预后的关系。方法回顾性调查慢性重型病毒性肝炎住院患者101例。按是否存在严重感染分为感染组与非感染组;同时按不同预后分为存活组与死亡组。比较感染组与非感染组之间肝肾功能、PTA、血常规、死亡率差异;比较存活组与死亡组之间感染率、血白细胞数差异。结果重型肝炎感染组患者血清TBIL、Cr高于非感染组患者(P值分别为0.013、<0.001),感染组患者血清PTA低于非感染组患者(P=0.001),差异有统计学意义;感染组患者死亡率(72.7%)高于非感染组患者死亡率(23.9%),差异有统计学意义(P<0.001);重型肝炎死亡组患者严重感染率(78.4%)、肺部感染率(49.1%)高于存活组患者(P值分别为<0.001、0.002),死亡组患者血白细胞数高于存活组患者,差异有统计学意义(P<0.001)。结论严重感染加重重型肝炎患者肝功能损害,增加其病死率。在临床上要合理使用抗菌素,加强各种感染的防控,以改善重型肝炎患者预后,提高其抢救成功率与治愈率。Objective To investigate the assosiation between serious infection and prognosis in patients with chronic severe viral hepatitis. Methods 101 Hospitalized patients with chronic severe viral hepatitis were studied retrospectively and divided into infected and non-infected groups by the existence of serious infection,as well as the survival and death groups by different prognosis. Liver and kidney function,prothrombin time activity,blood routine and mortality were compared between the infected and non-infected group while infection rate and white blood cells compared between the survival and death groups. Results The plasma levels of total bilirubin and creatinine in patients with severe infection were higher（P values were 0.013,0.001）,while prothrombin time activity was lower（P=0.001） than that in the non-infected group. Mortality（72.7%） was higher in the infected groups than that in the non-infected group（P 0.001）. Severe infection rate（78.4%）,lung infection rate（49.1%） and white blood cell counts were higher in the death groups than that in the survival group（P values were 0.001,0.002,0.001）. Conclusion Severe infection increased liver damage and mortality in patients with severe hepatitis. The reasonable use of antibiotics and the strength of infection prevention and control should be done in clinical working in order to improve the prognosis of severe hepatitis patients and increase their successful rescue rate and cure rate.

关 键 词：慢性 重型肝炎 感染 预后 

分 类 号：R575.1[医药卫生—消化系统]