161例乙型肝炎肝衰竭患者临床特征与转归分析  

Clinical characteristics and outcomes in 161 patients with hepatitis B-related liver failure

作　　者：高斯媛 胡克勤[2] 郭威[2] 丁红芳[2] 张振纲[2] 齐俊英[2] 

机构地区：[1]昆明市第三人民医院肝病二科,云南昆明650000 [2]华中科技大学同济医学院附属同济医院感染科

出　　处：《中西医结合肝病杂志》2011年第5期274-277,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨乙型肝炎肝衰竭临床特征与其转归的关系。方法:对161名住院乙型肝炎肝衰竭患者进行回顾性研究。并选取门诊病例进行前瞻性研究验证MELD模型。结果:多元逐步logistic回归分析显示,患者病死率与年龄>38.5岁,HBV DNA>1×106拷贝/ml,合并急性血吸虫感染,吸烟史,丙氨酸氨基转移酶水平,总胆红素水平,总胆固醇<1.4mmol/L,胆碱酯酶水平,凝血酶原时间,MELD评分相关。结论:年龄,HBV DNA载量,合并急性血吸虫感染,吸烟史,谷丙转氨酶、总胆红素、总胆固醇、胆碱酯酶水平,凝血酶原时间,MELD评分等是影响疾病转归的独立因素。Objective： To determine clinical characteristics and the related outcomes in patients with hepatitis B related liver failure. Methods： Retrospective analysis of 161 inpatients admitted to a university teaching hospital for HBV-related hepatic decompeansation. The baseline values were used for data analyses. A prospective study based on out-patient was carried out to detect MELD （the model for endstage liver disease） . Results： Multivariate stepwise logistic analysis showed that mortality rate was significantly correlated with age 〉 38.5 years, HBV DNA 〉 1 x 10e copy/ml, coexisting acute schistomatosis, cigarette use, elevated ALT and TBil level, TCh 〈 1.4mmol/1, and elevated Che, PT and MELD score. Conclusion： In this cohort of HBV patients presented with hepatic decompeansation, age, HBV DNA load, coexisting acute schistomatosis, cigarette use, and the levels of ALT, TBil, TCh, Che, PT, and MELD score are independent risk factors for in-hospital mortality.

关 键 词：乙型肝炎 肝衰竭 临床特征 转归 回顾性分析 

分 类 号：R512.62[医药卫生—内科学]