慢加急性肝衰竭合并肝性脑病159例生存分析  

Survival analysis of 159 patients with hepatic encephalopathy in acute-on-chronic liver failure

作　　者：崔燕平[1] 崔霞[1] 管珊[1] 李庆方[1] 王思奎[1] 

机构地区：[1]聊城市人民医院肝病科,山东省聊城252000

出　　处：《中国基层医药》2015年第9期1309-1312,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 对影响慢加急性肝衰竭（ACLF）伴肝性脑病（HE）患者预后的因素进行分析,探讨影响预后的危险因素.方法 回顾性分析159例ACLF伴HE患者的临床资料,以确定HE为起点,将患者分为生存组（13例）和死亡组（146例）,选择32个相关临床指标,用SPSS软件对相关数据进行单因素和多因素非比例风险的Cox模型分析.结果 ACLF伴HE患者1、3、6个月的生存率分别为20.13％、10.06％、8.18％,经Cox回归分析,筛选出HE分期、肝肾综合征（HRS）为独立的预后因素（χ2=18.344、11.368,均P＜0.05）,HE分期越高、出现HRS增加患者死亡风险,相对危险度（RR）分别为1.591、1.809.结论 HE分期、HRS是判断ACLF伴HE患者预后的重要指标.Objective To analyze the prognostic factors for patients with hepatic encephalopathy （HE） in acute-on-chronic liver failure（ACLF）.Methods A retrospective analysis was performed on 159 ACLF patients with HE.The hepatic encephalopathy was determined to baseline,the patients were divided into survivors（n =13） and nonsurvivors（n =146）,The 32 factors affecting the prognosis were analyzed by Cox proportional hazard model with SPSS.Results One-month,three-month,and six-month survival rates were 20.13%,10.06% and 8.18%,respectively.Cox regression analysis of prognostic factors showed that it could the stage of hepatic encephalopathy and HRS significantly improve the survival rate of the patients with HE in acute-on-chronic liver failure.The stage of hepatic encephalopathy and HRS could significantly decrease the survival rate of the patients（χ2 =18.344,11.368,all P 〈 0.05）,elevated the levels of hepatic encephalopathy （relative risk （RR） =1.591） and HRS （RR =1.809） indicate worse prognosis with hepatic encephalopathy in acute-on-chronic failure.Conclusion The stage of hepatic encephalopathy and HRS were independent risk factor sof prognosis in acute-on-chronic liver failure.

关 键 词：肝衰竭 肝性脑病 因素分析 统计学 

分 类 号：R575[医药卫生—消化系统]