影响重型肝炎患者预后的危险因素研究

Study on the risk factors influencing the prognosis of severe hepatitis

目的研究影响重型肝炎患者预后的危险因素。方法收集75例重型肝炎患者(存活组39例,死亡组36例)28项临床指标,采用Cox比例风险模型研究影响重型肝炎患者生存的危险因素与生存状态及生存时间的综合性量化关系。结果白细胞、血小板、总胆红素、碱性磷酸酶、胆固醇、凝血酶原活动度、透明质酸、肝性脑病、肝肾综合征、电解质紊乱、腹水、感染在存活组和死亡组之间差异有统计学意义(P<0.05)。Cox模型分析显示,凝血酶原活动度、肝性脑病、感染是影响重型肝炎患者预后的主要危险因素(相对危险度分别为0.963、4.107、0.258,P<0.05)。结论重型肝炎预后影响因素众多,凝血酶原活动度、肝性脑病和感染为主要危险因素,可望用于重型肝炎的预后判断。

Objective To Study the risk factors influencing prognosis of severe hepatitis. Methods 75 patients were divided into alive group （n = 39） and dead group （n = 36）. 55 patients were men, and 20 patients were women. The average age was （42.27 ± 12.28） years old （range from 17 to 65）. 28 clinical and laboratory parameters were collected as predictive risk factors. The relation between risk factors and survival time and status was analysed by Cox proportional hazards model. Results There were statistic difference between alive group and dead group in the risk factors such as WBC, PLT, TBil, ALP, CHO, PTA, HA, hepatic encephalopathy, hepatorenal syndrome, electrolyte disorder, ascites and infection （P〈0.05）. PTA, hepatic encephalopathy and infection were obtained as primary risk factors for predicting the prognosis of severe hepatitis （relative risk was 0. 963, 4. 107 and 0. 258, P〈0.05, respectively）. Conclusion There are three primary risk factors in many risk factors which may be useful for predicting the prognosis of severe hepatitis.