摘要
目的分析肠黏膜通透性(IP)改变与肝硬化患者Child-Pugh分级及预后的关系,为临床治疗方案制订、病情判定、预后评估提供参考。方法回顾性分析2019年7月至2020年7月本院收治并完成随访的60例肝硬化患者的临床资料,统计肝硬化患者Child-Pugh分级及预后不良情况,测定IP相关指标[D-乳酸、血清二胺氧化酶(DAO)、内毒素水平],分析IP改变与肝硬化患者Child-Pugh分级及预后的关系。结果60例肝硬化患者中,Child-Pugh分级为A级36例,占比60.00%;B级18例,占比30.00%;C级6例,占比10.00%;C级患者血清D-乳酸、DAO、内毒素水平、Child-Pugh评分均高于B级、A级患者,且B级患者高于A级患者,差异有统计学意义(P<0.05);Pearson检验结果显示,血清D-乳酸、DAO、内毒素水平与肝硬化患者Child-Pugh分级呈正相关(r>0,P<0.05);60例肝硬化患者中预后不良12例,占比20.00%;预后不良患者血清D-乳酸、DAO、内毒素水平均高于预后良好患者,差异有统计学意义(P<0.05);Logistic回归分析结果显示,血清DAO、D-乳酸、内毒素水平升高是肝硬化患者预后不良的危险因素(OR>1,P<0.05)。结论IP通透性改变与肝硬化患者Child-Pugh分级、预后密切相关,临床上可通过检测IP改变的相关指标,辅助临床预测肝硬化患者疾病进展、预后情况,对临床指导肝硬化治疗具有积极意义。
Objective To analyze the relationship between the change of intestinal permeability(IP)and the Child-Pugh grade and prognosis of patients with liver cirrhosis,so as to provide reference for making clinical treatment plan,judging the condition and evaluating the prognosis.Methods The clinical data of 60 patients with liver cirrhosis who were treated and followed up in our hospital from July 2019 to July 2020 were ret-rospectively analyzed.The Child-Pugh classification and poor prognosis of patients with liver cirrhosis were counted.The IP related indexes(D-lac-tic acid,serum diamine oxidase[DAO],endotoxin level)were measured,and the relationship between IP changes and Child-Pugh classification and prognosis of patients with liver cirrhosis was analyzed.Results Among the 60 patients with liver cirrhosis,Child-Pugh grading was A grade in 36 cases,accounting for 60.00%;B grade in 18 cases,accounting for 30.00%;C grade in 6 cases,accounting for 10.00%;serum levels of D-lactic acid,DAO,endotoxin,and Child-Pugh score in patients with grade C were higher than those in grades B and grades A,and the levels of serum D-lactic acid,DAO,endotoxin,and patients with grade B were higher than those grade A,and the difference was statistically significant(P<0.05).The Pearson test showed that serum D-lactic acid,DAO,and endotoxin levels were positively correlated with Child-Pugh grade in patients with liver cirrhosis(r>0,P<0.05);12 of the 60 patients with liver cirrhosis had poor prognosis,accounting for 20.00%(12/60);the serum D-lactic acid,DAO and endotoxin lev-els in patients with poor prognosis were higher than those in patients with good prognosis,and the difference was statistically significant(P<0.05);Logistic regression analysis showed that the increased levels of serum DAO,D-lactic acid and endotoxin were the risk factors of poor prognosis in patients with liver cirrhosis(OR>1,P<0.05).Conclusion The change of IP permeability is closely related to the Child-Pugh grade and prognosis of patients with liver cirrhosis,clinically
作者
黄茂辉
HUANG Maohui(Department of Infection,Shangrao People's Hospital,Shangrao,Jiangxi,334000,China)
出处
《当代医学》
2022年第12期35-38,共4页
Contemporary Medicine
