全身炎症反应综合征对肝硬化患者预后的影响

目的:探讨全身炎症反应综合征(SIRS)对肝硬化患者预后的影响。方法:104例肝硬化患者根据是否合并SIRS分为SIRS组(n=25)和非SIRS组(n=79),比较两组患者入院时呼吸、脉搏、平均动脉血压、体温、肝功能Child-Pugh分级及评分、血白细胞计数(WBC)、血清丙氨酸转氨酶(ALT)、总胆红素(TBil)、白蛋白(ALB)、肌酐(Cr)、国际标准化比值(INR)、严重并发症(肝性脑病、门脉高压性出血、肝肾综合征)发生率和死亡率。结果:SIRS组患者的体温、脉搏、呼吸频率、Child-Pugh评分、血WBC、TBil、ALB、Cr、INR及住院期间的死亡率、门静脉高压性出血、肝性脑病、肝肾综合征等并发症的发生率均明显高于非SIRS组(P0.05)。结论:合并SIRS的肝硬化患者肝功能较差、并发症多、死亡率高、预后差。

The Effect of Prognosis on Patients with Cirrhosis Complicated by Systemic Inflammatory Response Syndrome

Objective： To explore the significance of prognosis on patients with cirrhosis complicated by systemic inflammatory response syndrome （SIRS）. Methods： 104 patients with cirrhosis were divided into the SIRS group （n= 25） and the non-SIRS group （n=79） according to with or without SIRS. The temperature, pulse, respiratory rate, the Child-Pugh classification and score, white blood cell count （WBC）, serum alanine aminotransferase （ALT）, total bilirubin （TBil）, albumin （ALB）, creatinine （Cr）, international normalized ratio （INR）, the incidence of severe complications including hepatic encephalopathy,portal hypertensive bleeding and hepatorenal syndrome and the mortality were compared between the two groups. Results： The temperature, pulse, respiratory rate, Child-Pugh score, WBC, TBil, ALB, Cr, INR, and the incidence of portal hypertensive bleeding, hepatic encephalopathy, hepatorenal syndrome and the mortality of patients in SIRS group during hospitalization were significantly higher than those in the non-SIRS group （P〈0.05）. Conclusion： The patients with cirrhosis combined SIRS have poorer liver function, more complications incidence, higher mortality rate and poorer prognosis.