753例重型肝炎病原学及预后相关因素分析

Analysis of Etiologtic and Prognostic Factors in 753 Cases of Severe Hepatitis

目的了解各型重型肝炎患者的病原学及影响其预后的危险因素。方法采用回顾性调查分析方法,对753例重型肝炎患者的病原学、年龄、各项生化、PTA和病毒指标等预后相关因素应用SPSS13.0软件包进行统计分析。结果①各型重型肝炎的预后不同,各组间有显著性差异;②乙型肝炎是慢性重型肝炎的最主要病因;③年龄、凝血酶原活动度(PTA)、总胆红素(TB)、总胆固醇(CHO)是影响预后的重要的实验室指标;④乙肝HBeAg阴性且HBV-DNA高表达者,病死率增高,有显著差异。结论重型肝炎以慢性乙型重型肝炎为主,年龄、凝血酶原活动度(PTA)、总胆红素(TB)、总胆固醇(CHO)以及乙肝前C区基因变异与慢性重型肝炎预后相关,可作为评价预后的重要指标。

Objective To further understand severe hepatitis through analyzing the etiology and risk factors affecting the prognosis of severe hepatitis.Methods SPSS 13.0 software was used to analyze the etiology,age,biochemistry,PTA and virus examination results et al affecting the prognosis of 753 cases with severe hepatitis treated in the Sixth People′s Hospital of Hangzhou from 2005 to 2008.Results ①There were significant differences in the prognosis between various types of severe hepatitis.The prognosis of acute liver failure was worst.②Hepatitis B was the most dominating etiology.③Age,prothrombin activity（PTA）,total bilirubin（TBIL）,cholesterol（CHO）were important laboratory factors affecting the prognosis of severe hepatitis.④The ratio of patients who had a serum HBV DNA level more than 5 log copies/mL in HBeAg-negative patients was significantly.Conclusion Severe hepatitis was miainly chronic severe hepatitis B.Age,prothrombin activity（PTA）,total bilirubin（TB）,total cholesterol（CHO）,as well as hepatitis B pre-C gene mutation had association with prognosis of chronic severe hepatitis B,and can be used as an important prognostic indicator.