228例慢性重型乙型病毒性肝炎预后因素分析

Analysis of the factors influencing the prognosis of chronic severe hepatitis B

目的探讨影响慢性重型乙型病毒性肝炎预后的因素。方法对228例慢性重型乙型病毒性肝炎临床资料进行回顾性分析,总的病死率60.1%。结果病死组年龄、肝炎后肝硬化、血清胆红素水平、HBVDNA阳性率、肝性脑病、电解质紊乱、肝肾综合征、上消化道出血、继发感染发生率明显高于好转或治愈组(P<0.05);凝血酶原时间(42.02±16.86)秒明显较好转组延长(26.95±6.83)秒,P<0.01。结论中青年、胆红素血症越高、凝血酶原时间越长、并发肝炎后肝硬化、肝性脑病、电解质紊乱、继发感染、肝肾综合征及消化道出血是影响慢性重型乙型肝炎预后的危险因素。

Objective To explore the prognosis factors on the patients with chronic severe hepatitis B. Methods By analyzing the clinical data of 228 cases with chronic severe hepatitis B retrospectively. Fatality rate was 60.1% in patients with chronic severe hepatitis B. Results In death group, old, serum bilirub in level, appearance of HBVDNA positive, hepaticenc ephalopathy, gastrointestinal hemor --rhage, hepatorenal syndrome and secondary infection were higher than that in improvement group （P〈 0.01）. Prothrombin time（PT） in death group was significant higher than that in improvement group. Conclusions Ageyounger than50--year, high serum bili--rubin, long PT, complicated with hepaticenc ephatopathy, gastrointesinal hemorrhage, hepatorenal syndrome and infection are important factors influencing the prognosis of chronic severe hepatitis B.