乙型肝炎相关慢加急性肝衰竭患者预后的危险因素分析

石新星; 张艳琼; 朱鹏; 闫国华; 张长江; 王宇明

doi:10.3969/j.issn.1001-5256.2016.04.018

乙型肝炎相关慢加急性肝衰竭患者预后的危险因素分析

DOI: 10.3969/j.issn.1001-5256.2016.04.018

第三军医大学西南医院全军感染病研究所

基金项目:

国家“十二五”科技重大专项(2012ZX10002004)；国家自然科学基金面上项目(81270536)；

详细信息

中图分类号: R575.3;R512.62
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出版历程
- 出版日期: 2016-04-20

Prognostic risk factors in patients with hepatitis B virus- related acute- on- chronic liver failure

Department of Infectious Diseases, Southwest Hospital, Third Military Medical University

Research funding:

摘要

摘要:
目的探讨乙型肝炎相关慢加急性肝衰竭（HBV-ACLF）患者的临床特征及远期预后的危险因素。方法回顾性分析第三军医大学西南医院2010年1月-2015年1月住院的1116例HBV-ACLF患者的临床资料,观察影响患者1年生存时间及预后的危险因素,通过Cox回归模型筛选出影响预后的独立危险因素。计量资料组间比较采用t检验或t’检验,计数资料组间比较采用χ2检验。结果在随访的1年时间内,562例患者死亡,病死率为50.4%。生存组和死亡组比较:年龄、ALT、TBil、尿素氮、血肌酐、国际标准化比值、血清Na+、白细胞（WBC）、中性粒细胞百分比、血小板（PLT）、HBV DNA载量、MELD评分、腹水、自发性细菌性腹膜炎、消化道出血、肺部感染、脓毒症、电解质紊乱、肝性脑病及急性肾损伤（AKI）在2组间的差异均有统计学意义（P值均<0.05）。Cox回归分析结果显示:年龄、WBC、MELD评分、肝性脑病、电解质紊乱、AKI及PLT是HBV-ACLF患者1年病死率的独立危险因素（P值均<0.05）。结论 HBV-ACLF是一个高病死率疾病,...
- 肝功能衰竭 /
- 肝炎病毒,乙型 /
- 危险因素 /
- 预后
Abstract:
Objective To investigate the clinical characteristic and long- term prognosis risk factor of patients with hepatitis B virus- related acute- on- chronic liver failure( HBV- ACLF). Methods The clinical data of 1116 HBV- ACLF patients who were hospitalized in Southwest Hospital of Third Military Medical University from January 2010 to January 2015 were analyzed retrospectively. The risk factors for1- year survival time and prognosis were observed,and the Cox regression model was used to determine the independent risk factors for the prognosis of these patients. The t- test or t'- test was applied for comparison of continuous data between groups,and the chi- square test was applied for comparison of categorical data between groups. Results A total of 562 patients died within the 1- year follow- up period,and the fatality rate was 50. 4%. The comparison between the survival group and the death group showed that age,alanine aminotransferase,total bilirubin,urea nitrogen,serum creatinine,international normalized ratio,serum Na+,white blood cell( WBC),percentage of neutrophils,platelet( PLT),HBV DNA load,Model for End- Stage Liver Disease( MELD) score,ascites,spontaneous bacterial peritonitis,gastrointestinal bleeding,pulmonary infection,sepsis,electrolyte disturbance,hepatic encephalopathy,and acute kidney injury( AKI)were the risk factors for death within 1 year( all P < 0. 05). The Cox regression analysis showed that age,WBC,MELD score,hepatic encephalopathy,electrolyte disturbance,AKI,and PLT were the independent risk factors for the 1- year fatality in HBV- ACLF patients( all P < 0. 05). Conclusion Our findings show that HBV- ACLF has a high fatality rate and is often accompanied by serious complications.The major risk factors affecting the 1- year fatality in HBV- ACLF patients are age,WBC,MELD score,hepatic encephalopathy,electrolyte disturbance,AKI,and PLT.
- liver failure /
- hepatitis B virus /
- risk factors /
- prognosis

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