摘要
目的探讨乙型肝炎病毒(hepatitis B virus,HBV)相关亚急性肝衰竭患者预后影响因素,旨在为临床判断HBV相关亚急性肝衰竭预后及早期防治提供参考。方法选择2014年10月至2017年10月本院收治的HBV相关亚急性肝衰竭患者197例为研究对象。主要研究终点为患者6个月的病死率,采用电话随访或门诊定期随访,随访终点为患者死亡或肝移植。根据随访终点患者的生存状态,将入选患者分为生存组和死亡组。分析影响HBV相关亚急性肝衰竭患者生存质量的独立危险因素。结果至随访终点,患者生存132例(生存组),死亡65例(死亡组)。单因素分析结果显示,两组患者性别、平均体质指数、HBeAg阳性患者例数、Child分级、肾功能异常患者例数、HBV-DNA、总胆红素、直接胆红素、血红蛋白及白蛋白水平比较差异均无显著性(P_均> 0.05);死亡组患者年龄、终末期肝病模型(the model for end-stage liver disease,MELD)评分以及肝性脑病、肝肾综合征、合并感染发生率均显著高于生存组(P_均<0.05),凝血酶原活动度显著低于生存组(P <0.05)。多因素Logistic回归分析结果显示,年龄、肝性脑病、肝肾综合征、凝血酶原活动度及MELD评分是影响HBV相关亚急性肝衰竭患者生存质量的独立危险因素(P_均<0.05)。结论年龄、肝性脑病、肝肾综合征、凝血酶原活动度及MELD评分均为影响HBV相关亚急性肝衰竭患者预后的独立危险因素。
Objective To explore the influencing factors of prognosis in patients with hepatitis B virus(HBV)-related subacute liver failure,to provide reference for clinical judgement of prognosis and early prevention and treatment of HBV-related subacute liver failure.Method A total of 197 patients with HBV-related subacute liver failure admitted to our hospital from October 2014 to October 2017 were selected as the subjects.The main endpoint was 6 months mortality,follow up by telephone or by clinic regularly,the end point of follow-up was death or liver transplantation.According to the survival status of patients at the end of follow-up,all patients were divided into survival group and death group,analyzed the independent risk factors of quality of life in patients with HBV-related subacute liver failure.Result At the end of follow-up,132 patients survived(survival group)and 65 died(death group).Univariate analysis showed that there were no significant differences in gender,average BMI,HBeAg positive cases,Child classification,renal dysfunction,the levels of HBV-DNA,total bilirubin,direct bilirubin,hemoglobin and albumin between the two groups(Pall>0.05),the age,the model for end-stage liver disease(MELD)score and incidence of hepatic encephalopathy,hepatorenal syndrome and combined with infection in death group were significantly higher than those in survival group(Pall<0.05);the prothrombin activity in death group was significantly lower than that in survival group(P<0.05).Multivariate Logistic regression analysis showed that age,hepatic encephalopathy,hepatorenal syndrome,prothrombin activity and MELD score were independent risk factors for quality of life in patients with HBV-related subacute liver failure(Pall<0.05).Conclusion Age,hepatic encephalopathy,hepatorenal syndrome,prothrombin activity and MELD score are independent risk factors of patients with HBVrelated subacute liver failure.
作者
奚春妹
李红娜
XI Chun-mei;LI Hong-na(Department of Severe Liver Disease,Shanghai Public Health Clinical Center,Zhongshan Hosipital,Fudan University,Shanghai 201508,China)
出处
《中国医学前沿杂志（电子版）》
2018年第10期102-105,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
艾滋病和病毒性肝炎等重大传染病防治专项(2018ZX10302206-004-012)
关键词
乙型肝炎病毒
亚急性肝衰竭
预后
影响因素
Hepatitis B virus
Subacute liver failure
Prognosis
Influencing factor
作者简介
通讯作者:李红娜E-mail:lihongna0620@yeah.net。
