摘要
目的 探讨影响慢性乙型重型肝炎（Chronic severe hepatitis B,CSHB）预后的因素.方法 回顾性分析336例CSHB病例的临床资料,将其分为存活（n=137）和死亡（n=199）两组,比较两组患者年龄、性别、家族史、PTA、各种并发症及并发症数目、抗病毒、人工肝支持、前列地尔治疗等差异;对两组间统计学有差异的因素,采用多因素Logistic逐步回归分析筛选出影响患者顶后的危险因素.结果 患者年龄、凝血酶原活动度（PTA）及并发症腹水、感染、电解质紊乱、上消化道出血、肝性脑病、肝肾综合征及并发症数目比较,两组间差异有统计学意义（P＜0.01）;两组间性别、家族史及人工肝支持、前列地尔治疗情况比较,差异均无统计学意义（P＞0.05）;有无抗病毒治疗比较差异有统计学意义（P＜0.05）;多因素Logistic逐步回归分析显示PTA及并发症数目是CSHB患者死亡的危险因素,而抗病毒治疗是其保护因素.结论 CSHB的预后可能与患者年龄、PTA、有无并发症及并发症数目、抗病毒治疗等因素有关,其中PTA及并发症数目与CSHB患者的预后关系密切,抗病毒治疗可以降低其死亡率.
Objective To investigate the risk factors related to outcome of chronic severe hepatitis B. Methods A total of 336 consecutive patients with chronic severe hepatitis B （CSHB） were analysed retrospectively. According to the outcome, objects were divided into survival group（n =137） and death group（n = 199）, then to observe the differences between them in respect to age, sex, family history,prothrombin activity （ PTA ） , complications including ascites, infection, electrolyte disturbance, upper gastrointestinal bleeding, hepatic encephalopathy, hepatorenal sydrome and the corresponding quantity of complications in each individual, antivirus therapy, artificial liver support system （ALSS） therapy, and alprostadil therapy. Finally, risk factors related to prognosis were selected by stepwise Logistic regression analyse. Results In univariate analyse, significant differences between the two groups were found related to age, PTA, complications and its quantity（ P ＜ 0.01 for all）, and antivirus therapy （ P ＜ 0. 05 ） rather than sex, family history and treatment of ALSS or alprostadil. Logistic regression revealed that risk factors comprised of PTA and quantity of complications, antivirus therapy was the only protective factor. Conclusion A numbers of factors including age,PTA,complications and its quantity, and antivirus therapy affect the prognosis of CSHB, among which, antivirus therapy can reduce the death rate.
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
北大核心
2010年第6期458-460,共3页
Chinese Journal of Experimental and Clinical Virology
基金
国家＂十一五＂科技重大专项（2008ZX10005-007）
国家＂十一五＂科技重大专项一传染病防治关键技术平台（2009ZX10005-016）
浙江省中医药科技计划项目（2007 CB199）
