人工肝对晚期慢性乙型重型肝炎预后影响及分析方法的选择  

Analysis on the effects of artificial liver support system on prognosis of patients with later period of chronic severe hepatitis B and selection of proper analytical method

作　　者：周锐[1] 甘巧蓉[1] 郑彩霞[1] 李红霞[1] 周文[1] 黄建荣[2] 潘晨[1] 

机构地区：[1]福州市传染病医院(福建医科大学附属传染病医院),福州市350025 [2]浙江大学附属第一医院

出　　处：《中华实验和临床感染病杂志（电子版）》2012年第3期8-11,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：艾滋病和病毒性肝炎等重大传染病防治科技重大专项(No.2008ZX10002-005);福州市科技计划项目(No.2009-G-102)

摘　　要：目的通过前瞻性对照研究,探讨人工肝支持系统(ALSS)对晚期慢性乙型重型肝炎患者预后的影响及其分析方法的选择。方法选择2009年1月至2010年6月期间于本院住院的晚期慢性乙型重型肝炎患者30例,根据患者意愿分成人工肝治疗组和内科综合治疗组。所有患者均随访至2010年12月15日,分别记录治疗后30 d、60 d、90 d及最后统一随访时的生存状态及生存时间。用卡方检验分别比较两组患者治疗后30 d、60 d、90 d的存活率;用Kaplan-Meier分别绘制两组患者治疗后30 d、60 d、90 d及最后统一随访时的生存曲线,Log-Rank检验分析两组的生存率。结果两组间基线时基本临床资料无显著性差异;随访时间为6～24个月;卡方检验结果显示,两组患者入组后30 d、60 d的生存率比较具有统计学意义(P<0.05),但90 d时生存率差异无统计学意义;生存分析结果显示,两组患者治疗后30 d、60 d、90 d以及最后统一随访时生存率比较差异均具有统计学意义(P<0.05)。结论人工肝支持系统能提高晚期慢性乙型重型肝炎患者治疗后的生存率;生存分析可用于分析一种治疗方法对患者预后的影响。Objective To analyse the effects of artificial liver support system （ALSS） on prognosis in later period of chronic severe hepatitis B patients and to select the proper analytical method through the prospective, controlled clinical study. Methods Total of 30 later period of chronic severe hepatitis B patients in our hospital from January 2009 to June 2010 were enrolled, prospectively. According to the wish of the patients, they were divided into the treatment group and the control group. All patients were followed up to December 15th, 2010. The survival states and survival times of all patients at the time of 30 d, 60 d, 90 d after enrolled and at the last follow-up time were recorded. The survival rate at the time of 30 d, 60 d, 90 d after enrolled were compared, respectively. The survival curve at the time after enrolled and at the last follow-up was drawn and the survival rates were detected. Results There was no significant difference between the two groups in the clinical features at baseline. The follow-up time was from 6 to 24 months. The survival rate of the treatment group were significantly higher than of the control group at the time of 30 d and 60 d after enrolled （ P 〈 0.05 ）, but not at the time of 90 d. The survival rate of the treatment group was significantly higher than of the control group at the time of 30 d, 60 d, 90 d after enrolled and at the last follow-up time, respectively （P 〈 0.05 ）. Conclusions The artificial liver support system might improve the prognosis of patients with chronic severe hepatitis B. The effects of a treatment on prognosis could be analyzed by the survival analysis.

关 键 词：肝炎病毒 乙型 肝功能衰竭 肝 人工 预后 

分 类 号：R512.62[医药卫生—内科学]