91例肝性脊髓病患者预后影响因素的Logistic回归分析  

Logistic regression analysis of prognostic factors in 91 patients with hepatic myelopathy

作　　者：余思邈[1] 张宁[1] 杜宁[1] 王立福[1] 孙永强[1] 景婧[1] 周超[1] 张帆[1] 王睿林[1] 朱云[1] 

机构地区：[1]解放军第三○二医院中西医结合肝病诊疗与研究中心,北京100039

出　　处：《肝脏》2016年第8期617-619,共3页Chinese Hepatology

摘　　要：目的对影响肝性脊髓病(HM)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91例HM患者的临床资料,观察12例好转者和79例恶化者的临床资料,包括:年龄,性别,肝病病程,Child-Pugh分级,饮酒史,有无门体静脉分流手术、脾切除术史,肝硬化并发症(腹水、胸水、上消化道出血、腹膜炎、肝性脑病、肝肾综合征),合并症(糖尿病、高血压病),实验室指标(TBil、Alb、ALT、AST、CHE、WBC、PLT、PTA、BLA)等,并进行单因素分析,进一步行Logistic回归分析。结果单因素分析结果提示,PTA、CHE、Child-Pugh分级两组比较差异有统计学意义(P<0.05),与好转组比较,恶化组具有更低的PTA值和CHE值以及更高的Child-Pugh分级(P<0.05)。将单因素分析中有意义变量经Logistic回归分析结果提示,CHE、Child-Pugh分级影响HM患者的预后(P<0.05),Child-Pugh分级越高,预后越差(OR=32.825);CHE值越小,预后越差(OR=0.243)。结论 CHE、Child-Pugh分级是HM预后的独立危险因素,CHE越低、Child-Pugh分级越高,HM患者预后越差。Objective To investigate the prognostic factors for patients with hepatic myelopathy （HM）and its risk factors.Methods In this retrospective cohort study,clinical data of 91 cases with HM admitted in our hospital from January 2006 to April 2015 was collected.The patients were divided into improved group （n=12）and deteriorated group （n=79）.The correlation between prognosis and clinical features,which including age,sex,duration of liver disease,Child-Pugh score,drinking alcohol hobby,history of splenectomy,history of transjugular intrahepatic portosystemic shunt, complications of liver cirrhosis,comorbidies,laboratory indicators and so on,were analyzed by univariate analysis and further investigated by logistic regression analysis.Results Univariate analysis revealed that prothrombin activity （PTA）, cholinesterase （CHE）and Child-Pugh score were important factors affecting the prognosis （P 〈0.05）.Compared with the improvement group,the deterioration group showed lower levels of PTA and CHE,higher Child-Pugh score （P 〈0.05 ）. Furthermore,logistic regression analysis indicated that low level of CHE and high Child-Pugh score had statistically significant correlation with poor prognosis of HM patients （P 〈0.05）,with odds ratio as 0.243 and 32.825 respectively. Conclusion CHE and Child-Pugh score are independent risk factors for prognosis of HM patients.For those patients,low level of CHE and high rank of Child-Pugh class predicts poor prognosis.

关 键 词：肝性脊髓病 预后 LOGISTIC 回归分析 

分 类 号：R575[医药卫生—消化系统] R744[医药卫生—内科学]