肝硬化肝性脑病患者预后相关因素分析  

Prognostic Factors of Hepatic Encephalopathy in Cirrhotic Patients

作　　者：吴梓苗[1] 冯杰[1] 张爱军[1] 

机构地区：[1]浙江省慈溪市人民医院感染科,315300

出　　处：《中国全科医学》2011年第9期948-950,共3页Chinese General Practice

摘　　要：目的探讨影响肝硬化肝性脑病(hepatic encephalopathy,HE)患者预后的相关因素。方法将288例肝硬化HE患者按预后分为治疗好转组和恶化死亡组,比较两组患者临床资料,并对有统计学意义的单因素进一步行Logistic回归分析探讨影响患者预后的因素。结果两组患者性别、年龄、HE病史的构成比比较,差异均无统计学意义(P>0.05);而肝硬化原因、HE分期的构成比比较,差异均有统计学意义(P<0.05)。两组患者并发糖尿病、腹腔积液、便秘的发生率比较,差异均无统计学意义(P>0.05);而并发感染、消化道出血、血肌酐异常、Child-Pugh分级为C级的发生率比较,差异均有统计学意义(P<0.05)。两组患者血氨、凝血酶原时间、血清蛋白、血钾的异常率比较,差异均无统计学意义(P>0.05);而总胆红素、血钠的异常率比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示:HE分期、Child-Pugh分级、血肌酐、血钠、消化道出血进入回归模型。结论 HE分期、Child-Pugh分级、血肌酐、血钠、消化道出血是影响肝硬化HE预后的独立危险因素,临床上对具有这些危险因素的患者应加以重视。Objective To investigate the prognostic factors of hepatic encephalopathy（HE） in cirrhotic patients. Methods 288 cirrhotic HP patients were divided,based on prognosis,into groups improved and deteriorated.The clinical data were analyzed and single factor Logistic regression analysis was used to explore the factors influencing patients′ prognoses. Results No significant difference in constituent ratio of gender,age,HE history between 2 groups（P0.05）,but there was in constituent ratio of cause of cirrhosis,HE staging（P0.05）.There was not difference in complications by diabetes,seroperitoneum,constipation（P0.05）,but there was in complications by infection,gastrointestinal bleeding,abnormal serum creatinine,C grade of Child-Pugh（P0.05）.No difference in abnormal rates of blood chloride,prothrombin time,serum protein,serum potassium（P0.05）,but there was in abnormal rates of total bilirubin,serum sodium（P0.05）.Multiple Logistic regression analysis showed that HE staging,Child-Pugh grading,serum creatinine,sodium,gastrointestinal bleeding entered regression model. Conclusion HE staging,Child-Pugh grading,serum creatinine,serum sodium,gastrointestinal bleeding are independent risk factors influencing cirrhotic HE prognosis,which should be paid special attention to.

关 键 词：肝硬化 肝性脑病 预后 

分 类 号：R657.31[医药卫生—外科学]