摘要
目的探讨伴或不伴HIV/AIDS肝衰竭患者的临床特征。方法回顾性分析2017年1月至2020年8月重庆市公共卫生医疗救治中心收治的47例HIV/AIDS肝衰竭患者及同期收治的108例非HIV/AIDS肝衰竭患者的一般资料、病因、分型、实验室检查、并发症及预后。结果两组肝衰竭患者均以中年男性为主,组间性别、年龄、住院时间差异无统计学意义(P>0.05)。最常见病因均为肝炎病毒及药物,分别占(28例)59.57%、(77例)71.30%及(18例)38.30%、(24例)22.22%,由HBV导致的肝衰竭所占比例最高,分别占(27例)57.45%和(75例)69.44%。分型均以慢加急性(亚急性)肝衰竭为主,分别占(33例)70.21%及(71例)65.74%。并发症发生率最高的为感染,分别占(33例)70.21%和(61例)56.48%,以腹膜炎和肺炎为主,分别占(22例)66.67%、(42例)68.85%及(14例)42.42%、(25例)40.98%。两组的真菌感染率(16例,34.04%;4例,3.70%)、HBV规律治疗率(10例,21.28%;9例,8.33%)、无效/死亡比例(30例,63.83%;45例,41.67%)、病因中药物因素占比(18例,38.30%;24例,22.22%)、肝性脑病发生率(14例,29.79%;15例,13.89%),SCRP(40.23 mg/L,17.60 mg/L)、PCT(1.00 ng/mL;0.79 ng/mL)、PT(28.20 s;23.75 s)、INR(2.37;1.99)、Alb(25.72 g/L;28.89 g/L)、CHE(2074.64 U/L;2810.79 U/L)、CD4 T淋巴细胞(186.76/μL;390.24/μL)差异有统计学意义(P<0.05)。结论HIV/AIDS肝衰竭患者肝脏损害更严重,肝脏合成功能更差,无效/死亡比例更高。
Objective To investigate the clinical characteristics of liver failure patients with or without Human Immunodeficiency Viral infection/Acquired Immune Deficiency Syndrome(HIV/AIDS).Methods A retrospective review of 47 cases of liver failure patients with HIV/AIDS(group 1)and 108 cases of liver failure patients without HIV/AIDS(group 2)collected from January 2017 to August 2020 was performed by analyzing their general data,etiologies,classifications,laboratory examination,complications and prognosis.Results The liver failure patients in both groups were mainly middle-aged men.There were no significant differences in gender,age and length of stay between two groups of patients(P>0.05).The most common etiology was hepatitis virus,accounting for 59.57%(28 cases)and 71.30%(77 cases)in group 1 and group 2 of patients,respectively,followed by drug that accounting for 38.30%(18 cases)and 22.22%(24 cases),respectively.The highest proportion of liver failure was caused by HBV,accounting for 57.45%(27 cases)and 69.44%(75 cases)respectively.It was mainly acute(subacute)-on-chronic according to clinical classification,accounting for 70.21%(33 cases)and 65.74%(71 cases),respectively.The highest incidence of complications was infection,accounting for 70.21%(33 cases)and 56.48%(61 cases),respectively.The infections were mainly due to peritonitis and pneumonia,accounting for 66.67%(22 cases)and 68.85%(42 cases),and 42.42%(14 cases)and 40.98%(25 cases),respectively.There were significant differences in fungal infection rate(16 cases,34.04%vs 4 cases,3.70%),regular treatment of HBV(10 cases,21.28%vs 9 cases,8.33%),ineffectiveness/mortality ratio(30 cases,63.83%vs 45 cases,41.67%),the proportion of drug factors in etiology(18 cases,38.30%vs 24 cases,22.22%),incidence of hepatic encephalopathy(14 cases,29.79%vs 15 cases,13.89%)as well as the levels of SCRP(40.23 mg/L vs 17.60 mg/L),PCT(1.00 ng/mL vs 0.79 ng/mL),PT(28.20 s vs 23.75 s),INR(2.37 vs 1.99),ALB(25.72 g/L vs 28.89 g/L),CHE(2074.64 U/L vs 2810.79 U/L),CD4(186.76 cells/uL vs
作者
田泽敏
田翀
TIAN Ze-min;TIAN Chong(Department of Gastroenterology,Chongqing Public Health Medical Center,Chongqing 400036,China)
出处
《肝脏》
2022年第3期321-324,共4页
Chinese Hepatology
关键词
肝衰竭
人类免疫缺陷性病毒/获得性免疫缺陷综合征
临床特征
Liver failure
Human Immunodeficiency Viral infection/Acquired Immune Deficiency Syndrome
clinical features
