慢加急性肝衰竭合并乙型肝炎患者的诱因探究及中医证候规律分析方法  

Incentive Exploration and TCM Syndrome Analysis of Patients with Acute and Chronic Liver Failure Combined with Hepatitis B

作　　者：余晓珂[1] 任平[2] 

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008 [2]河南中医药大学,河南郑州450046

出　　处：《中医学报》2016年第7期1063-1065,共3页Acta Chinese Medicine

基　　金：河南省科技攻关项目(0424420047)

摘　　要：目的:分析慢加急性肝衰竭合并乙型肝炎患者的诱因及中医证候规律。方法:随机选取2013年5月—2015年5月就诊的慢加急性肝衰竭合并乙型肝炎的患者186例作回顾性研究,对其病因等情况进行统计分析。结果:活动性乙型肝炎病毒(hepatitis B virus,HBV)及HBV是乙型肝炎患者并发慢加急性肝衰竭的主要诱因,其次为非病毒感染等,在所有诱因当中,HBV合并肝癌的死亡率最高,达100.0%,而好转率最高的是并发戊型病毒性肝炎(viral hepatitis type E,HEV)及自身免疫性肝病。乙型肝炎表面抗原(hepatitis B surface antigen,HBe Ag)阳性患者DNA水平较阴性患者高,差异有统计学意义(P<0.05),但死亡率无显著差异(P>0.05)。乙型肝炎病毒YMDD变异患者较非变异患者的DNA水平高,差异有统计学意义(P<0.05)。结论:活动性HBV或变异是慢加急性肝衰竭合并乙肝的主要诱发因素,非病毒感染、病毒感染、消化道出血、酒精及药物等对慢加急性肝衰竭合并乙型肝炎也具有一定的诱导作用。Objective： To investigate the incentive and TCM Syndrome laws of patients with acute and chronic liver failure combined with hepatitis B. Methods： 186 patients with acute on chronic liver failure with hepatitis B in our hospital from May 2013-May2015 were randomly selected and retrospective analysis statistically of its causes and so on. Results： active hepatitis B virus（ HBV）,HBV and then the non-viral infection are the major causes of the occurrence of acute and chronic liver failure combined with hepatitis B. In all the incentives,the mortality rate of HBV coincident with hepatocellular carcinoma is the highest,reaching100. 0 percent,while the highest rate of improvement happens to the patients with viral hepatitis type E（ HEV） and autoimmune liver disease. There is high DNA level of hepatitis B surface antigen（ HBe Ag） in positive patients compared with that of the negative patients,with the difference being statistically significant（ P 〈0. 05）,but there is no significant difference in mortality rate between the two（ P 〈0. 05）. There is a relatively higher DNA level in patients with YMDD mutation compared with that in patients without YMDD mutation,with significant difference（ P 〈0. 05）. Conclusion： The active HBV or the variant of it is the main predisposing factor of acute and chronic liver failure with hepatitis B,and non-viral infection,viral infection,gastrointestinal bleeding,alcohol and drugs also have a certain inductive effect on the occurrence of acute and chronic liver failure combined hepatitis B.

关 键 词：慢加急性肝衰竭 乙型肝炎 中医证候 

分 类 号：R259.126.2[医药卫生—中西医结合]