慢加急性肝衰竭101例临床分析

目的探讨不同发病基础上的慢加急性肝衰竭在临床表现、实验室指标、预后是否存在差异。方法回顾分析慢加急性肝衰竭101例,按发病基础分为慢性HBV携带者、慢性肝炎、肝硬化3组,比较它们临床及实验室指标,并发症发生率及预后。结果（1）3组患者的ALT、ALB、CHE差异有统计学意义（P〈0．001）,慢性HBV携带者组中的ALT、ALB、CHE明显高于其它两组。（2）3组并发肝性脑病、腹水、自发性腹膜炎及感染并发症的发生率有统计学差异（P〈0．05）。（3）3组患者发病年龄以慢性HBV携带者组最小,肝硬化组年龄最大。3组预后,以慢性HBV携带者组最好,肝硬化组最差。结论慢性HBV携带者、慢性肝炎、肝硬化基础上发病的急性肝衰竭,在生化指标、合并症、预后均有差异。肝硬化组预后最差,应尽早进性肝移植。

Clinical analysis of 101 cases with acute-on-chronic liver failure

Objective In order to observe whether there are differences in clinical manifestations,laboratory profiles theincident rate of complication and prognosis among 101 patients with acute - on - chronic liver failure. Methods 101 patients with acute -on -chronic liver failure were divided into three groups： chronic asymptomatic HBV carrier（7 cases）, patients with chronic hepatitis （42 cases） and patients with cirrhosis（52 cases）. The clinical manifestations, laboratory profiles incident rate of complication and prognosis in three groups were investigated. Results （ 1 ） There were significant differences in ALT, AST, ALB and CHE between the three groups （P 〈 0. 001 ）. （2）There were significant differences in the incident rate of complication between the three groups, such as hepatic encephalopathy, ascites, spontaneous bacterial peritonitis and infection（P 〈 0.05）. （3） The prognosis of the patients with chronic asymptomatic HBV carrier group was the best. Conclusion There were significant differences in clinic feature and prognosis between the three groups. The prognosis of patients with cirrhosis was the worst. Liver transplantation should be carried out at early stage in cirrhotic patients.