慢加急性肝衰竭与慢性肝衰竭的临床分析

目的探讨慢加急性肝衰竭与慢性肝衰竭的临床差异。方法选取肝组织病理诊断为慢性重型肝炎97例,按肝衰竭诊疗指南分为慢加急性肝衰竭29例和慢性肝衰竭68例,比较2组临床及检验指标特点。结果慢加急性肝衰竭在慢性重型肝炎中占29.9%。慢性肝衰竭与慢加急性肝衰竭的区别在于前者有肝硬化,患者年龄较大,ALB、PLT、HB更低,更易出现腹水,而ALT较低。结论慢性肝衰竭是在肝硬化基础上发生的慢性重型肝炎,临床上与慢加急性肝衰竭的主要区别是,除有肝衰竭的表现外还存在脾功能亢进和门脉高压的表现。

Clinical analysis of acute-on-chronic liver failure and chronic liver failure

Objective To investigate the clinical difference between acute-on-chronic liver failure and chronic liver failure. Methods A total of 97 patients with chronic severe hepatitis, diagnosed by pathology, were classified to 29 cases of acute-on-chronic liver failure and 68 cases of chronic liver failure according to"Diagnosis and treatment guideline for liver failure". The clinical and laboratory characteristics of the two groups were compared. Results Acute-on-chronic liver failure accounted for 28.9% in chronic severe hepatitis. Compared with patients with acute-on-chronic liver failure, those with chronic liver failure, elder in age, had liver cirrhosis with much lower levels of ALT, ALB, PLT, HB and were most likely to have ascites. Conclusion As chronic severe hepatitis developed on the basis of liver cirrhosis, chronic liver failure differs from acute-on-chronic liver failure in such clinical symptoms as hypersplenism and portal hypertension.