慢加急性肝衰竭与慢性肝衰竭的临床特点和预后分析  

Clinical characteristics and prognosis of acute-on-chronic liver failure and chronic liver failure

作　　者：曹玲[1] 王崇慧[1] 占国清[1] 

机构地区：[1]湖北医药学院附属人民医院肝病科,湖北十堰442000

出　　处：《临床消化病杂志》2015年第1期13-16,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]探讨慢加急性肝衰竭(ACLF)与慢性肝衰竭(CLF)的临床特点和预后差异。[方法]75例慢性重型肝炎患者按肝衰竭诊疗指南分为ACLF组(27例)和CLF组(48例),比较2组一般情况、实验室指标、常见并发症、Child-Pugh评分及预后。[结果]CLF组年龄和病程均明显高于ACLF组(P<0.05或P<0.01),2组性别差异无统计学意义;ACLF组血清ALT、TBil、ALB及Na+水平高于CLF组,GLO、TBA低于CLF组(P<0.05或P<0.01);ACLF组血常规参数WBC、HGB和PLT高于CLF组,凝血指标PT低于CLF组(P<0.05或P<0.01),2组Fib差异无统计学意义;ACLF组腹水和肝性脑病发生率低于CLF组(P<0.05或P<0.01),2组腹腔感染、上消化道出血、肝肾综合征及电解质紊乱差异无显著性;ACLF组Child-Pugh评分(9.2±1.7)低于CLF组(12.0±2.5),其预后优于CLF组(P<0.05或P<0.01),2组住院时间差异无统计学意义。[结论]ACLF和CLF患者在年龄、病程、实验室指标、并发症腹水和肝性脑病发生率、Child-Pugh评分及预后均有差异。[Objective]To investigate the clinical characteristics and prognosis difference between acuteon-chronic liver failure（ACLF）and chronic liver failure（CLF）.[Methods]Seventy-five patients with chronic severe hepatitis were classified to ACLF group（27cases）and CLF group（48cases）according to＂Diagnosis and treatment guideline for liver failure＂.The general situation and laboratory parameters,complications,Child-Pugh score and prognosis of the two groups were compared.[Results]Age and disease course of CLF group were significantly higher than those of ACLF group（P0.05 or P〈0.01）,there was no significant difference in gender ratio between the two groups.Serum ALT,TBil,ALB and Na＋levels were higher and GLO,TBA were lower in ACLF group than those in CLF group（P0.05 or P〈0.01）.The blood parameters including WBC,HB and PLT were higher and the coagulation PT was lower in ACLF group than those in CLF group（P0.05 or P〈0.01）,there was no significant difference for Fib between the two groups.The incident rates of ascites and hepatic encephalopathy were lower in ACLF group than those in CLF group（P0.05 or P〈0.01）,there was no significant difference in abdominal infection,upper gastrointestinal hemorrhage,hepatorenal syndrome and electrolyte imbalance between the two groups.Child-Pugh score in ACLF group（9.2±1.7）was lower than that in CLF group（12.0±2.5）（P〈0.01）,the prognosis of ACLF group was better than that of CLF group（P0.05）,there was no significant difference in hospital time between the two groups.[Conclusion]There are significant difference in age,disease course,laboratory indicators,incident rates of complication ascites and hepatic encephalopathy,Child-Pugh score and prognosis between ACLF and CLF patients.

关 键 词：慢加急性肝衰竭 慢性肝衰竭 临床特点 预后 

分 类 号：R575.3[医药卫生—消化系统]