利尿剂治疗肝硬化腹水疗效的部分影响因素分析

Clinical factors influencing the therapeutic response to diuretic treatment of ascites in liver cirrhosis

目的探讨利尿剂治疗肝硬化腹水疗效的部分影响因素。方法收集93例肝硬化腹水患者的临床相关指标,通过单因素分析和Logistic回归分析,分析临床各项指标与利尿剂治疗肝硬化腹水疗效的关系。结果在利尿剂治疗肝硬化腹水有效和无效组中,肝硬化并发症、肝功能分级、血电解质水平、尿量、血肌酐水平和腹水程度比较差异具有显著性(P<0.05);将具有显著性差异的影响因素纳入Logistic回归模型,结果显示,肝硬化腹水利尿剂治疗有效的主要预测因素为肝功能分级(P=0.006,OR=0.326)和血肌酐水平(P=0.044,OR=0.169)。结论肝功能分级和血肌酐水平是影响肝硬化腹水利尿剂疗效的重要因素。

Aim To investigate the clinical factors influencing the therapeutic response to diuretic treatment of ascites in liver cirrhosis. Methotis Correlated clinical indexes were collected from 93 liver cirrhotic patients with ascites. The relationship between these clinical indexes and the therapeutic response to diuretic treatment of ascites in liver cirrhosis was analyzed by one-way analysis and Logistic regression model. Resulets Significant differences of complication and childs pugh score and plasma creatinine level and urine volume and plasma electrolyte concentrations and the degree of ascites were found between the group responded to and not responding to diuretic treatment of ascites in liver cirrhosis （ P 〈 0.05 ）. Childs-Pugh score （ P = 0.006, OR = 0. 326） and plasma creatinine level （ P = 0. 044, OR = 0. 169） were the risk factors of cirrhotic patients with ascites who are responsiveness for diuretic in logistic regression model. Conculsion Childs-Pugh score and plasma creatinine level were the risk factors influencing the therapeutic response to diuretic treatment of ascites in liver cirrhosis.