摘要
目的研究影响肝肾综合征预后的因素、建立预后判断模型。方法选择126例肝肾综合征的病例，观察56项可能与本病预后有关的指标，涉及个人情况、病史、症状、体征、实验室检查等方面，用COX比例风险模型及Kaplan—Meier进行分析。结果肝性脑病（HE）及其程度、消化道出血（GIB）、血中性粒细胞数（N1）、肌酐（Cr）是影响预后的独立因素。危险指数P1=0．711HE＋0．836GIB＋0．052N1＋0．002Cr（N1、Cr为原测值；消化道出血，有=1，无=0；肝性脑病，无：0，Ⅰ期=1，Ⅱ期=2，Ⅲ=3，Ⅳ期=4）。当PI〈1时，平均生存期42d；1≤PIE3，平均生存期15d；PI〉3，平均生存期2d。结论肝性脑病及其程度、消化道出血、血中性粒细胞数、肌酐是影响预后的独立因素，可用于建立预后判断模型，本预后模型在临床工作中有助于预后判断、疗效评价，在治疗研究中可用于设定配对对照组。
Objective To identify the factors that may influence the prognosis of patients with hepatorenal syndrome and try to establish a prognostic model. Methods Data of 126 patients with hepatorenal syndrome were analyzed and 56 indexes that might affect the prognosis were focused on, involving history, symptoms, signs and lab findings. Cox model and Kaplan-Meier survival analysis were used. Results Many factors were found to affect the prognosis independently, including hepatic encephalopathy （HE） and its degree, gastrointestinal bleeding（GIB）, blood neutrophil count （N1） and serum creatinine （Cr）. The prognosis model was established as the following equation where PI represents prognosis index： PI=O. 711HE ＋0.836GIB ＋0.052N1 ＋0.002Cr（GIB：no =0, yes =1; HE： no =0, phaseⅠ =1, phaseⅡ -2, phase Ⅲ =3, phase Ⅳ =4）. When PI〈1, the average survival time was 42 days; when 1 ≤ PI≤3,the average survival time was 15 days; when P1 〉 3, the average survival time was 2 days. Conclusion The results obtained from this study may help in estimation of diagnosis, analysis of illness state and evaluation of therapy in clinical work.
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2012年第2期127-129,共3页
Chinese Journal of Experimental and Clinical Virology
基金
广东省自然科学基金项目（S2011010004680）
关键词
肝炎
乙型
慢性
肝肾综合征
预后
模型
统计学
Hepatitis B, chronic
Hepatorenal syndrome
Prognosis
Models, statistical
