乙型肝炎肝衰竭患者预后影响因素研究

目的探讨影响乙型肝炎肝衰竭患者预后的相关因素。方法回顾性分析2008年3月-2013年10月福建医科大学孟超肝胆医院肝病科确诊为乙型肝炎肝衰竭患者500例,统计在治疗随访中肝衰竭预后好转或者病情加重的例数,并结合临床检查,采用Pearson单因素分析及Logistic回归分析确定影响乙型肝炎肝衰竭患者预后的相关危险因素。结果 Pearson单因素分析提示患者出现预后病情恶化与血清总胆红素(TBIL)、直接胆红素(DBIL)、白蛋白(ALB)、除乙肝外其他肝病病史、凝血酶原时间(PT)、肺部并发感染、肝性脑病、电解质紊乱、血肌酐、入院后抗病毒治疗情况、胆碱酯酶、血脂、血清纳指标有关(P0.05);Logistic回归分析提示,除乙肝外其他肝病病史、PT延长、肺部并发感染、出现肝性脑病、入院后未接受正规抗病毒治疗是乙型肝炎肝衰竭患者预后不良的危险因素(P0.05)。结论除乙肝外其他肝病病史、PT延长、肺部并发感染是影响乙型肝炎肝衰竭预后的危险因素,入院后对患者进行正规的抗病毒治疗有利于改善患者的预后。

Related factors affecting the prognosis of patients with hepatitis B and liver failure

Objective To explore the related factors affecting the prognosis of patients with hepatitis B and liver failure.Methods Five hundred cases of hepatitis B and liver failure patients in the Mengchao Hepatobiliary Hospital were studied restrospectively.Pearson single factor analysis and Logistic regression analysis were used to determine the risk factors of prognosis in patients with hepatitis B and liver failure.Results The single factor Pearson analysis showed that TBIL,DBIL,ALB,other liver disease history except for hepatic B,PT,pulmonary infection,serum creatinine,admission antiviraltherapy,cholinesterase,blood fat and serum sodium were related factors of patients with worsening prognosis （P ＜ 0.05）.Logistic regression analysis showed other liver disease history except for hepatic B,prolonged PT,pulmonary infection,hepatic encephalopathy after admission,without formal antiviral therapy were the risk factors of patients with hepatitis B and liver failure （P ＜ 0.05）.Conclusion Other liver disease history except for hepatic B,prolonged PT,pulmonary infection were risk factors of prognosis of patients with hepatitis B and liver failure,and regular anti-viral treatment can improve prognosis of patients with hepatitis B and liver failure.