摘要
目的探讨影响慢性乙型肝炎患者并发肝衰竭死亡的危险因素。方法回顾性分析2019年1月至2021年2月在广东省韶关市粤北人民医院接受诊治的140例慢性乙型肝炎并发肝衰竭患者的临床资料,按照患者接受内科综合治疗后是否存活分为生存组(治疗后临床症状好转,n=77)、死亡组(治疗后无效死亡,n=63)。比较两组患者各项临床资料,采用单因素和多因素Logistic回归分析影响乙型病毒性肝炎患者并发肝衰竭死亡的危险因素。结果本研究经单因素分析结果显示,病程、血氨水平、CTP评分、MELD评分、血钠水平、年龄、碱性磷酸酶水平、转氨酶水平、血清胆红素水平、凝血酶原时间、肝性脑病、肝肾综合征、消化道出血的发生对乙型病毒性肝炎患者并发肝衰竭死亡有一定影响(均P<0.05)。经进一步多因素分析结果显示,高龄、高碱性磷酸酶水平、高转氨酶水平、高血清胆红素水平、凝血酶原时间延长、肝性脑病、肝肾综合征、消化道出血的发生是影响乙型病毒性肝炎患者并发肝衰竭死亡的独立危险因素(OR=1.347、1.029、1.654、1.352、1.274、0.081、16.415、0.937,均P<0.05)。结论高龄、高碱性磷酸酶水平、高转氨酶水平、高血清总胆红素水平、凝血酶原时间延长、肝性脑病、肝肾综合征、消化道出血的发生是影响乙型病毒性肝炎患者并发肝衰竭死亡的独立危险因素。
Objective To explore the risk factors that affect the survival of chronic hepatitis B(CHB)patients complicated with liver failure.Methods The clinical data of 140 CHB patients complicated with liver failure were retrospectively analyzed.The patients were divided into a survival group(clinical symptoms improved after treatment,n=77)and a death group(death after treatment,n=63)according to whether they survived after comprehensive medical treatment.The clinical data of these two groups of patients were compared.Single and multivariate logistic regression analyses were used to identify the risk factors that affect the survival of CHB patients complicated with liver failure.Results The result of univariate analysis showed that the course of disease,blood ammonia level,CTP score,MELD score,blood sodium level,age,alkaline phosphatase level,transaminase level,serum bilirubin level,prothrombin time,the occurrence of encephalopathy,hepatorenal syndrome,and gastrointestinal hemorrhage were the factors that impact on the survival of CHB patients with liver failure(all P<0.05).Further multi-variate analysis showed that advanced age,high levels of alkaline phosphatase,transaminase,serum bilirubin,prolonged prothrombin time,the occurrences of hepatic encephalopathy,hepatorenal syndrome,and gastrointestinal hemorrhage are independent risk factors for the survival of CHB patients with liver failure(OR=1.347,1.029,1.654,1.352,1.274,0.081,16.415,0.937,respectively,all P<0.05).Conclusion Old age,high levels of alkaline phosphatase,transaminase,serum total bilirubin,and prolonged prothrombin time,the occurrences of hepatic encephalopathy,hepatorenal syndrome,and gastrointestinal hemorrhage are risk factors that impact on the survival of CHB patients with liver failure.
作者
陈姣艳
陈斌
曹冬容
朱蔓然
焦志勇
秦永军
夏悯馨
CHEN Jiao-yan;CHEN Bin;CAO Dong-rong;ZHU Man-ran;JIAO Zhi-yong;QIN Yong-jun;XIA Ming-xin(Department of Gastroenterology,North Guangdong People's Hospital,Shaoguan 512026,China)
出处
《肝脏》
2021年第9期994-997,共4页
Chinese Hepatology
基金
韶关市卫生健康科研项目(Y20208)。
关键词
慢性乙型肝炎
肝衰竭
死亡
预后
危险因素
Chronic hepatitis B
Liver failure
Death
Prognosis
Risk factors
