急性肝炎合并凝血障碍的患者入院和随访期V因子与VII因子水平的预测价值  

The predictive value of admission and follow up factor V and VII levels in patients with acute hepatitis and coagulopathy

作　　者：Elinav E. Ben-Dov I. Hai-Am E. 赵天智 

出　　处：《世界核心医学期刊文摘（胃肠病学分册）》2005年第5期55-55,共1页Core Journals in Gastroenterology

摘　　要：Low factor V and VII levels are bad prognostic indicators in fulminant hepatic failure (FHF). The prognostic importance of admission versus follow up levels of these factors in patients with acute hepatitis and coagulopathy without encephalopathy has not been evaluated. Clinical and laboratory data from 68 consecutive patients with acute hepatitis and coagulopathy but without encephalopathy, during a 6-year period, was retrospectively evaluated. Sixty patients (88%) demonstrated improvement in liver function and coagulation (‘survivors’), while 8 patients (12%) died or underwent OLT (‘non-survivors’). Survivors had higher admission (P < 0.005) and follow up factor VII levels (P < 0.005) than non-survivors. Follow up factor V levels were higher in survivors (P < 0.02), while admission factor V level was not different between groups (P=NS). Multivariate logistic regression analysis demonstrated that admission factor VII levels predicted outcome (P < 0.006). Area under the ROC curve of factor VII was larger than that of factor V (0.885 and 0.715, respectively, P < 0.02). After 3 days of hospitalization, factor V levels, but not factor VII, independently predicted outcome (P < 0.04). In patients with hepatitis and coagulopathy without encephalopathy at presentation, admission factor VII level may serve as a reliable prognostic marker. Subsequently, during hospitalization, changes in factor V are better outcome indicators.Low factor V and VII levels are bad prognostic indicators in fulminant hepatic failure (FHF). The prognostic importance of admission versus follow up levels of these factors in patients with acute hepatitis and coagulopathy without encephalopathy has not been evaluated. Clinical and laboratory data from 68 consecutive patients with acute hepatitis and coagulopathy but without encephalopathy, during a 6-year period, was retrospectively evaluated. Sixty patients (88%) demonstrated improvement in liver function and coagulation (‘survivors’), while 8 patients (12%) died or underwent OLT (‘non-survivors’). Survivors had higher admission (P < 0.005) and follow up factor VII levels (P < 0.005) than non-survivors. Follow up factor V levels were higher in survivors (P < 0.02), while admission factor V level was not different between groups (P=NS). Multivariate logistic regression analysis demonstrated that admission factor VII levels predicted outcome (P < 0.006). Area under the ROC curve of factor VII was larger than that of factor V (0.885 and 0.715, respectively, P < 0.02). After 3 days of hospitalization, factor V levels, but not factor VII, independently predicted outcome (P < 0.04). In patients with hepatitis and coagulopathy without encephalopathy at presentation, admission factor VII level may serve as a reliable prognostic marker. Subsequently, during hospitalization, changes in factor V are better outcome indicators.

关 键 词：急性肝炎 VII因子 V因子 预测价值 凝血障碍 因子水平 肝功能衰竭 肝性脑病 原位肝移植 凝血功能 

分 类 号：R575.1[医药卫生—消化系统]