HBV阳性与肝内胆汁淤积症对重症急性胰腺炎患者预后的交互作用  

Interaction of HBV positive and intrahepatic cholestasis on prognosis of patients with severe acute pancreatitis

作　　者：刘松华 莫湘 黄大荣 陈艳斌 李明灯 莫瑶 LIU Song-hua;MO Xiang;HUANG Da-rong;CHEN Yan-bin;LI Ming-deng;MO Yao(Department of Gastroenterology,Wuzhou Traditional Chinese Medicine Hospital,Wuzhou 543002,China)

机构地区：[1]广西梧州市中医医院消化内科,梧州市543002

出　　处：《广西医学》2021年第10期1190-1193,共4页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(Z20170941)。

摘　　要：目的探讨HBV阳性与肝内胆汁淤积症(IHC)对重症急性胰腺炎(SAP)患者预后的交互作用。方法纳入198例SAP患者,收集其相关临床资料。采用Logistic回归模型分析HBV阳性及IHC对SAP患者预后的作用,并构建相乘与相加模型分析HBV阳性及IHC对SAP患者预后的交互作用。结果198例患者中,单独HBV阳性12例,单独IHC感染21例,HBV阳性与IHC感染共存为9例;167例患者存活,31例患者死亡。在控制相关混杂因素后,与单纯SAP的患者相比,合并HBV阳性患者、合并IHC患者、同时合并HBV阳性及IHC患者的死亡风险均升高(均P<0.05);HBV阳性与IHC对SAP患者预后的影响存在相乘、相加的交互作用(均P<0.05)。结论HBV感染与IHC均会影响SAP患者预后,若两者同时存在,可产生正向协同的交互作用,给SAP预后造成不良影响。Objective To explore the interaction of HBV positive and intrahepatic cholestasis(IHC)on the prognosis of patients with severe acute pancreatitis(SAP).Methods A total of 198 SAP patients were enrolled and their relevant clinical data were collected.Logistic regression model was used to analyze the effects of HBV positive and IHC on the prognosis of SAP patients,and multiplicative and additive models were constructed to analyze the interaction of HBV positive and IHC on the prognosis of SAP patients.Results Of the 198 patients,12 were simple HBV positive,21 were simple IHC infection,and nine were HBV positive complicated with IHC infection;167 cases survived and 31 died.After controlling the relevant confounding factors,compared with patients with simple SAP,patients with concomitant HBV positive,concomitant IHC,or concomitant HBV positive and IHC had increased risk of death(all P<0.05).There were multiplicative and additive interactions in the effects of HBV positive and IHC on the prognosis of patients with SAP(all P<0.05).Conclusion Both HBV infection and IHC might affect the prognosis of SAP patients.They might produce a positive synergistic interaction in the case of appearing concurrently,which will have adverse effects on the prognosis of SAP.

关 键 词：重症急性胰腺炎 乙型肝炎病毒 肝内胆汁淤积症 交互作用 合并症 预后 

分 类 号：R576.1[医药卫生—消化系统]