影响慢性重型肝炎预后相关指标的多因素回归分析

Logistic regression analysis of multiple factor that may influence the prognosis of chronic hepatic failure

目的研究影响慢性重型肝炎病情的危险因素与预后的相关性。方法选择我院感染科收治的慢性乙型重型肝炎患者28例,分病情好转组和恶化组。分别观察两组患者的年龄,并发症发生情况(腹水、原发性细菌性腹膜炎、消化道出血、肝性脑病、肝肾综合征),相关实验室检查指标(部分凝血酶原时间(PT)、凝血酶原活动度(PTA)、国际标准化指数(INR)、凝血因子V(FV:C)、纤维蛋白原(FIB)、D二聚体(D-D)、总胆固醇(TC)、总胆红素(TBil)、白蛋白(ALB)、前白蛋白(PRE-A)、丙氨酸转氨酶(ALT)、血清尿素(BUN)、血肌酐(SCR)、血小板(PLT)。对以上各指标进行Logistic单因素和非条件多因素分析。结果多因素分析后两组间在胆固醇(TC)、凝血因子V(FV:C)和腹水三个指标上有显著差异(P<0.05)。结论胆固醇(TC)、凝血因子V(FV:C)和腹水可作为慢性乙型重型肝炎预后的判定指标,对指导临床有重要价值。

Objective To investigate the correlation between the risk factors and prognosis of chronic hepatic failure. Methods We selected 28 patients with chronic hepatic failure in our Department of Infection Diseases from June 2007 to January 2008. The patients were divided into improved group and exacerbation group. We review the data of age ; complications like ： ascites, primary bacterial peritonitis, digestive tract hemorrhage, hepatocerebral disease, hepatorenal syndrome; laboratory examinations like： prothrombin time （PT）, prothrombin time activity （PTA）, International ratio （INR）, blood coagulation factor V （ FV ： C ）, fibrinogen （ FIB）, D - dimer （ D - D）, total cholesterol （ TC ）, total bilirubin （ TBil）, albumin （ ALB）, prealbumin （ PRE - A）, alanine aminotransferase （ ALT）, Blood urea （ BUN ）, serum creatinine （ SCR）, blood platelet（PLT）. Analyze the index above with SPSS 10. 0 by logistic regression. Results total cholesterol （TC）, blood coagulat on factor V （ FV ： C） and ascites were significantly different between the two groups （ P 〈 0. 05 ）. Conclusion TC, F V：C and ascites are valuable in predicting patients with chronic hepatic failure.