乙型肝炎肝衰竭短期预后的影响因素  

Analysis of short-term prognostic factors in patients with hepatitis B virus-related liver failure

作　　者：彭蕾[1] 周学士[1] 甘建和[1] 黄小平[1] 潘林林[1] 赵卫峰[1] 

机构地区：[1]苏州大学附属第一医院感染科,江苏省苏州市215006

出　　处：《世界华人消化杂志》2012年第28期2732-2736,共5页World Chinese Journal of Digestology

基　　金：十二五艾滋病和病毒性肝炎等传染病防治科技重大专项基金资助项目;No.2012X10002004008~~

摘　　要：目的:探讨影响乙型肝炎肝衰竭患者短期(3mo)预后的危险因素并构建预测模型.方法:回顾性分析2005-06/2008-09在苏州大学附属第一医院就治的乙型肝炎肝衰竭患者137例,观察其3mo的生存情况,应用t检验、2检验及Logistic回归分析筛选影响短期预后的独立危险因子.结果:137例患者短期生存率63.8%(86/137)、死亡率为36.2%(51/137).存活组和死亡组患者年龄,肝硬化,总胆红素、血清白蛋白、血小板数、国际标准化比率(international normalized ratio,INR)、MELD分值、Child-Pugh分值及并发症肝性脑病、肝肾综合征、肺部真菌感染、消化道出血、腹水、自发性腹膜炎频数均存在统计学差异(P<0.05),分别为0.035、0.001、0.001、0.001、0.001、0.001、0.001、0.001、0.001、0.001、0.001、0.001、0.001、0.001.多因素Logistic回归分析显示年龄、INR值及并发症肝性脑病、肺部真菌感染与乙型肝炎肝衰竭短期预后有关.结论:高龄、INR值、并发肝性脑病及肺部真菌感染是影响乙型肝炎肝衰竭短期预后的独立危险因素.AIM： To investigate the risk factors that influ ence short-term （3 mo） prognosis in patients with hepatitis B virus （HBV）related liver failure and to establish a prognostic model.METHODS： A retrospective analysis of 137 pa tients with HBV-related liver failure treated at the First Affiliated Hospital of Soochow University from June 2005 to September 2008 was performed to observe their 3-month survival. The t-test, chisquare test and logistic regression analysis were used to identify independent risk factors affecting 3-month prognosis in these patients.RESULTS： Of the 137 patients with HBV-related liver failure, 86 （63.8%） were alive and 51 （36.2%） died. Univariate analyses indicated that age, liver cirrhosis, total bilirubin （TBil）, albumin （ALB）, platelet ,international normalized ratio （INR）, MELD, Child-Pugh, complicating he patic encephalopathy, hepatorenal syndrome, pulmonary fungal infection, variceal bleeding, ascites, and spontaneous bacterial peritonitis were significant risk factors affecting 3-month prognosis in patients with HBV-related liver failure （P = 0.035, 0.001, 0.001, 0.001, 0.001, 0.001, 0.001, 0.001, 0.001, 0.001, 0.001, 0.001, 0.001, 0.001, respectively）. Multivariate Logistic regression analyses demonstrated that age, INR, hepatic en cephalopathy, and pulmonary fungal infection were independent risk factors affecting 3-month prognosis in these patients.CONCLUSION： Age, INR, hepatic encephalopa thy, and pulmonary fungal infection are inde pendent risk factors affecting short-term prog- nosis in patients with HBV-related liver failure.

关 键 词：乙型肝炎病毒 肝衰竭 预后 危险因素 

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