全身炎症反应综合征与重型肝炎

目的 探讨全身炎症反应综合征(SIRS)在重型肝炎患者中的发病率和临床特点,SIRS对重型肝炎患者生存率及预后的影响.方法 回顾性分析141例重型肝炎患者的临床资料,按照是否合并SIRS分为SIRS组及非SIRS组,分析两组患者的临床特点、并发症、12周生存率,并探讨重型肝炎患者死亡的预测因素.结果 SIRS在重型肝炎患者中发病率为58.87%.SIRS组及非SIRS组患者在合并感染、肝性脑病、腹水、肝肾综合征方面差异有统计学意义(P<0.01).合并感染的患者以腹腔及肺部感染为主.两组患者12周累计生存率分别为22.9%与55.2%,差异有统计学意义(P<0.01).结论 SIRS在重型肝炎患者中发病率较高,SIRS与感染、肝性腩病、腹水、肝肾综合征关系密切,合并SIRS使患者生存率明显下降,SIRS是重型肝炎患者预后不良的一个独立危险因素,防治SIRS的发生、发展可以降低重型肝炎患者的死亡率.

Systemic inflammatory response syndrome and serious hepatitis

Objective To investigate the incidence, clinical feature, survival rate(12 weeks) and the predictive factors of mortality in patients with systemic inflammatory response syndrome(SIRS) and serious hepatitis. Methods Through retrospective study over a period of 3 years(2005-2008), 141 clinical cases of serious hepatitis were discussed. 83 patients with SIRS served as SIRS group, others served as non-SIRS group. The clinical feature, complications, survival rate(12 weeks) and the predictive factors of mortality were investigated. Results In this study, the incidence of SIRS in serious hepatitis was 58.87% .There were statistical differences between the two grouos in the incidence of infection,hepatic encephalopathy, ascites and hepatorenal syndrome(P<0.01). The celiac and pulmonary infection were the main compli-cations of serious hepatitis with infection. The accumulative survival rate(12 weeks) were 22.9% and 55.2% respectively in two groups(P<0.01 ). Conclusions Tire incidence of SIRS is extremely higher in patients with serious hepatitis. SIRS is associated with the infection, hepatic encephalopathy, ascites and hepatorenal syndrome. The presence of SIRS is a major independent prognostic factor in patients with serious hepatitis. This suggests that preventing and treating SIRS could decrease the mortality in patients with serious hepatitis.