慢加急性乙型肝炎肝衰竭患者发生肝肾综合征的影响因素研究  

Study on the risk factors of the occurrence of hepato renal syndrome for patients with acute on chronic hepatitis B liver failure

作　　者：朱喜增[1] 翟玉峰[1] 王江华[2] 

机构地区：[1]南阳市中心医院感染科,河南省南阳473009 [2]北京大学人民医院北京大学肝病研究所

出　　处：《中国医师杂志》2014年第9期1196-1199,共4页Journal of Chinese Physician

基　　金：国家自然科学基金（30901256）

摘　　要：目的 探讨分析慢加急性乙型肝炎肝衰竭并发肝肾综合征（HRS）的影响因素.方法 选取2009年1月至2013年12月本院收治的60例慢加急性乙型肝炎肝衰竭患者为研究对象,通过单因素和多因素回归分析患者的基础临床资料、并发症发生情况及基线时临床检测指标,筛选慢加急性乙型肝炎肝衰竭患者肝肾综合征发生的独立危险因素.结果 60例慢加急性乙型肝炎肝衰竭患者发生HRS 17例,发病率为28.3％;多因素Logistic回归分析结果显示血清白蛋白、血钠、肝功能分级（Child-Pugh评分）、晚期肝病模型（MELD）评分、原发性细菌性腹膜炎、上消化道出血、腹水、肝性脑病是慢加急性乙型肝炎肝衰竭患者发生肝肾综合征的危险因素（P＜0.05）.结论 慢加急性乙型肝炎肝衰竭患者发生肝肾综合征的患病率较高,动态监测各种敏感指标并及时采取相应的预防及治疗措施,对改善患者预后具有十分重要的意义.Objective To investigate and analyze the risk factors of the occurrence of hepato renal syndrome （Hepatorenal syndrome,HRS） for patients with acute on chronic hepatitis B liver failure.Methods Sixty cases of patients with acute on chronic hepatitis B liver failure from January 2009 to December 2013 in our hospital were selected as the research objects.The single factor and multi-factor regression analyses were in patients with the basic clinical data,and the complications and the baseline clinical testing index of patients.The independent risk factors of the occurrence of HRS for patients with acute on chronic hepatitis B liver failure were screened.Results The cases of the occurrence of HRS for patients with acute on chronic hepatitis B liver failure was 17 among 60 cases with a incidence of 28.3 % ; The results of multivariable logistic regression analysis showed that serum albumin,serum sodium,liver function grade （Child-Pugh score）,model for end-stage liver disease （MELD） index,primary bacterial peritonitis,upper gastrointestinal hemorrhage,ascites,and hepatic encephalopathy were the risk factors of the occurrence of HRS for patients with acute on chronic hepatitis B liver failure （P 〈 0.05）.Conclusions The occurrence of HRS for patients with acute on chronic hepatitis B liver failure is higher.The various sensitive indicators should be monitored dynanically,and the relevant prevention and treatment measures should be taken in time.It has a significantly scientific merit to improve the prognosis of patients.

关 键 词：肝炎 乙型/并发症 肝功能衰竭/病因学 肝功能衰竭 急性/并发症 肝功能衰竭/并发症 慢性病 肝肾综合征/病因学 危险因素 

分 类 号：R575[医药卫生—消化系统]