摘要
目的:探讨影响肝性脑病患者预后的因素.方法:选择2005年2月至2011年2月诊治的肝性脑病患者90例,严格纳入标准,排除各种可导致昏迷及精神行为异常的疾病.对患者行全面检查,重点观察血液中凝血酶原活动度、血清白蛋白、谷氨酰转肽酶、血清钠、血清胆红素水平、Child-Pugh分级及是否伴有上消化道出血、腹水、原发性肝癌、肝肾综合征、继发感染.观察30 d内患者生存及死亡情况,研究以上因素与患者预后的关系.样本的比较采用2检验,以P<0.05为具有统计学意义.结果:高血清胆红素(>51.3 mol/L)、低凝血酶原活动度(<30%)、低血清白蛋白(28g/L)、低血钠(<135mmol/L)、Child-Pugh分级C级及伴有腹水、上消化道出血、肝肾综合征、继发感染的患者30 d内病死率明显增高,与相应的生存患者相比,差异有统计学意义(P<0.05).血液谷氨酰转肽酶水平及是否合并原发性肝癌对患者30 d内病死率影响不大(P>0.05).结论:多种因素可以影响肝性脑病的预后,及时的诊断和准确的治疗可以挽救患者生命,提高其生活质量.
Objective：To explore the influencing factors of the prognosis of hepatic enecphal-opathy（HE）.Methods： 90 cases of hepatic encephalopathy which had been treated in affiliated hospital of Jianghan university were selected,with a strict adoption standard which excluded all kinds of diseases probably leading to coma and behavior disorder.Clinical and laboratory parameters（prothrombin activity,serum albumin,glutamyl transpeptidase,serum sodium,serum bilirubin,Child-Pugh classification,upper gastrointestinal bleeding,ascites,primary liver cancer,hepatorenal syndrome,secondary infection）were investigated.The above factors and their relationship with prognosis（within 30 days of survival and death） were researched.The samples were compared using chi-square test,P 0.05 had statistical significance.Results： The mortality within 30 days of patients with high serum bilirubin（ 51.3 mol/L）,low prothrombin activity（ 30%）,low serum albumin（28 g/L）,low blood sodium（ 135 mmol/L）,Child-Pugh grade C and ac-companied with ascites,upper gastrointestinal bleeding,hepatorenal syndrome,infection was sig-nificantly increased,comparing with the other patients.The difference was statistically significant（P 0.05）.The influence of blood transpeptidase level on the mortality within 30 days of patients was not significant（P 0.05）,as well as accompanying with primary liver cancer or not.Conclusion： Multiple factors can influence the prognosis of hepatic encephalopathy.Timely diagnosis and proper treatment can save lives of the patients,and improve the prognosis of the patients.
出处
《江汉大学学报（自然科学版）》
2011年第4期62-64,共3页
Journal of Jianghan University：Natural Science Edition
关键词
肝性脑病
预后
病理生理学
hepatic encephalopathy
prognosis
pathological physiology
作者简介
张勇（1959-），男，湖北武汉人，副主任医师，主要从事消化内科临床研究
