乙型肝炎肝硬化患者并发肝硬化性心肌病的危险因素分析  

Risk factors for cirrhotic cardiomyopathy in patients with hepatitis B-associated cirrhosis

作　　者：吴文杰 江丽萍 王洪燕 陈阮琴 陈明胜 WU Wen-jie;JIANG Li-ping;WANG Hong-yan;CHEN Ruan-qin;CHEN Ming-sheng(Department of General Medicine,Mengchao Hepatobiliary Hospital of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学孟超肝胆医院综合内科,福州350001

出　　处：《肝脏》2020年第9期955-958,共4页Chinese Hepatology

基　　金：福州市科技计划项目(2018-S-103-2)。

摘　　要：目的探讨乙型肝炎肝硬化并发肝硬化性心肌病(CCM)的影响因素,及早预防CCM。方法采用病例对照研究,严格按照病例和对照的纳入和排除标准,纳入2015年2月—2018年7月在福建医科大学孟超肝胆医院收住院的乙型肝炎肝硬化并发CCM的患者45例组成病例组;选择同期住院的乙型肝炎肝硬化未并发CCM的患者100例作为对照。服从正态分布的计量资料两组间比较用独立样本t检验,非正态分布的计量资料两组间比较采用Mann-Whitney U检验,两组间计数资料比较用χ2检验,多因素分析采用logistic回归分析,评价各个因素在乙型肝炎肝硬化患者并发CCM中的作用。结果多因素logistic回归分析发现:影响乙型肝炎肝硬化并发CCM有统计学意义的变量为Child-Pugh分级(OR=3.794,95%CI:1.320~10.901)、MELD评分(OR=1.218,95%CI:1.107~1.341)、年龄(OR=1.079,95%CI:1.034~1.125)及Hb(OR=0.978,95%CI:0.962~0.994)。结论 Child-Pugh分级、MELD评分、Hb及年龄是乙型肝炎肝硬化并发CCM的独立危险因素。Objective To investigate the influencing factors of cirrhotic cardiomyopathy(CCM)in patients with hepatitis B-associated cirrhosis and to prevent CCM as soon as possible.Methods With strict inclusion and exclusion criteria,45 hepatitis B-associated cirrhosis patients complicated with CCM who were hospitalized in our hospital from February 2013 to July 2015 were selected as the case group,and 100 patients without CCM in the same period were selected as the control group.A case-control study was conducted.Independent-sample t test was used to analyze the measurement data obeying normal distribution,Mann-Whitney U test was used to analyze the measurement data with non-normal distribution,χ2 test was used to analyze the counting data,and multivariate logistic regression analysis was used to evaluate the effect of various factors on CCM in hepatitis B-associated cirrhosis patients.Results The Child-Pugh grade[odds ratio(OR)=3.794,95%confidence interval(CI):1.320~10.901],the model for end-stage liver disease(MELD)score(OR=1.218,95%CI:1.107~1.341),age(OR=1.079,95%CI:1.034~1.125)and hemoglobin(Hb)(OR=0.978,95%CI:0.962~0.994)were statistically significant variables affecting the development of CCM in patients with hepatitis Bassociated cirrhosis.Conclusion Child-Pugh grade,MELD score,Hb and age are independent risk factors for CCM in hepatitis B-associated cirrhosis patients.

关 键 词：乙型肝炎肝硬化 肝硬化性心肌病(CCM) 危险因素 

分 类 号：R575.2[医药卫生—消化系统] R512.62[医药卫生—内科学] R542.2[医药卫生—临床医学]