慢性乙型肝炎病毒感染并发慢加急性肝衰竭的影响因素分析  

Influence factors analysis of acute-on-chronic liver failure effects of chronic hepatitis B virus infection

作　　者：杨美荣[1] 杨艳红[3] 张国顺[2] 王国立[3] 路静 

机构地区：[1]河北联合大学附属医院血液科,河北省唐山市063000 [2]河北联合大学附属医院消化内科,河北省唐山市063000 [3]河北联合大学 [4]唐山市丰润区燕山医院

出　　处：《中国综合临床》2015年第5期413-416,共4页Clinical Medicine of China

摘　　要：目的探讨慢性乙型肝炎病毒（HBV）感染并发慢加急性肝衰竭的影响因素。方法选择2008年7月至2013年12月在河北联合大学附属医院住院的慢性HBV感染并发慢加急性肝衰竭患者186例（病例组），选择同期住院的慢性HBV感染患者186为对照组。采用面对面问卷方式填写调查表，分析HBV感染并发慢加急性肝衰竭的影响因素。结果多因素条件Logistic回归分析显示：影响慢性HBV感染并发慢加急性肝衰竭的9个变量如下：8个危险因素：病毒重叠感染（OR=6．523，95％CI：2．034～10．030），药物应用（OR=9．012，95％CI：3．018—13．241），饮酒（OR=7．252，95％CI：1．985—11．247），细菌感染（OR=4．378，95％CI：2．032—5．648），外科手术（OR=8．514，95％CI：2．114～17．253），情绪紧张及劳累（OR=2．217，95％CI：1．729～5．648），遗传（OR：11．124，95％CI：2．168～13．429），高PCR—HBVDNA定量（OR=1．628，95％CI：1．504～3．282）；1个保护因素：使用抗病毒药物（OR=0．163，95％CI：0．085～0．417）。结论病毒重叠感染、应用肝毒性药物、病前饮酒、细菌感染、外科手术、情绪紧张及劳累、父母遗传、高PCR-HBVDNA定量是影响慢性HBV感染并发慢加急性肝衰竭的因素，使用抗病毒药物是保护性因素。Objective To investigate the influence factors of chronic hepatitis B virus（HBV） infection complicated with chronic liver failure. Methods One hundred and eighty-six chronic HBV infection patients with chronic liver failure were selected as our subjects, who were hospitalized in the Affiliated Hospital of Hebei United University from Jul. 2008 to Dec. 2013 and they served as case group. Meanwhile, 186 patients with chronic HBV infection were selected and served as control group, who were hospitalized during the same period. A self-mad questionnaire was used to collect the information. The influence factors related to HBV infection complicated with acute on chronic liver failure were recorded. Results Multivariate conditional Logistic regression analysis showed that 8 variables were risk factors in terms of chronic HBV infection complicated with acute on chronic liver failure and they were virus overlap infection（ OR = 6. 523,95%CI： 2. 034 -10. 030）, drug application （ OR = 9. 012,95% CI： 3. 018 - 13. 241 ）, alcohol （ OR = 7. 2520, 95% CI： 1. 985 - 11. 247 ） , bacterial infection（ OR = 4. 378,95% CI： 2. 032 - 5. 648 ）, surgical operation （ OR = 8.514,95% CI： 2. 114-17. 253） ,emotional stress and fatigue（ OR=2. 217,95%CI： 1. 729-5. 648）, genetic（ OR= 11. 124,95% CI： 2. 168-13.429）, high PCR-HBVDNA quantity（ OR = 1. 628,95% CI： 1. 504- 3. 282）. And one protective factor was the usage of antiviral drug （ OR = 0. 163,95% CI： 0. 085 - 0. 417 ） . Conclusion The risk factors include virus over infection, application of hepatotoxic drugs, disease before drinking, bacterial infection, surgical operation, emotional stress and fatigue, the genetic parents and high PCR-HBVDNA quantification;and antiviral drugs application is the protective factor in terms of Chronic HBV infection complicated with acute-on-chronic liver failure.

关 键 词：慢性乙型肝炎病毒感染 慢加急性肝衰竭 影响因素 

分 类 号：R512.62[医药卫生—内科学]