乙型病毒性肝炎导致的慢性肝功能衰竭患者死亡危险因素分析

目的探讨乙型病毒性肝炎导致的慢性肝功能衰竭患者死亡危险因素及预后。方法回顾性分析116例乙型病毒性肝炎导致的慢性肝功能衰竭患者的临床资料，根据患者预后情况分为好转组及死亡组，分析其死亡危险因素及12周生存率。结果两组患者PA、PTA、血氨、Child—Pugh评分比较差异有统计学意义（P〈0．01）．两组患者ALB、血清Na比较差异有统计学意义（P〈0．05）。Child—Pugh评分增加、血氨增高及PTA降低是慢性肝功能衰竭患者死亡的很好预测因素（P〈0．01），PA及血清Na降低亦是患者死亡的预测因素（P〈0．05）。乙型病毒性肝炎导致的慢性肝功能衰竭患者12周生存率为34．48％。结论Child-Pugh评分、血氨、PTA、PA、血清Na与患者预后相关，提示降低血氨、改善凝血状态、纠正低蛋白血症及低钠血症可以改善患者预后、降低死亡率；

Analysis on Prognostic Factors for Chronic Liver Failure from Hepatitis B

Objective To analyze the prognostic factors for chronic liver failure resulting from hepatitis B. Methods A total of 116 patients with chronic liver failure resulting from hepatitis B, over a period of three years （ 2005 - 2008 ） , were retrospectively studied. All the Patients were divided into improved group （ n = 40 ） and dead group （ n = 76 ） according to their prognoses. Clinical feature, 12-week survival rate and predictive factors of mortality were investigated. Results In the study, serum prealbumin, prothrombin time activity, blood ammonia and Child-Pugh score were remarkably different between the two group （P 〈 0.01 ） , so were serum albumine and natrium （ P 〈0. 05 ）. The increases in Child-Pugh score and blood ammoniemia, as well as the decrease in prothrombin time activity, were the major independent prognostic factors in the patients with chronic liver failure from hepatitis B （ P 〈 0.01 ） , and the decreases in serum prealbumin and serum natrium were also the prognostic factors （P 〈 0.05 ）. The 12 week survival rate was 34.48% in those with chronic liver failure from hepatitis B. Conclusion It is suggested that Child-Pugh score, blood ammonia, prothrombin time activity, serum prealbumin, and serum natrium are associated with the prognoses of the patients with chronic liver failure resulting from hepatitis B. Their mortality may be decreased by means of preventing or treating ammoniemia, prolonging prolhrombin time, and correcting hypoproteinemia and hyponatremia.