乙型肝炎病毒致慢加急性肝衰竭156例诱因及预后分析

Inducement and Prognosis of Acute-on-chronic Liver Failure Caused by Hepatitis B Virus:an Analysis of 156 Cases

目的探讨乙型肝炎(下简称乙肝)病毒致慢加急性肝衰竭(ACLF)的常见诱因及预后。方法分析乙肝病毒致ACLF 156例患者的临床资料,对其发病诱因及预后等进行统计,用多因素Logistic回归分析观察不同诱因对预后的影响。结果乙肝病毒活动为乙肝病毒致ACLF最常见的诱因(占60.26%),多因素Logistic回归分析结果显示病毒变异、自行停药与疾病的预后相关(P<0.05),OR值分别为7.858、2.745。结论病毒变异、自行停药是影响乙肝病毒致ACLF预后的独立危险因素。合理使用抗病毒药物控制乙肝病毒活动,尽量避免诱发因素,有利于减少ACLF的发生、改善预后。

Objective To investigate the common inducements and prognosis of acute-on-chronic liver failure（ACLF） caused by hepatitis B virus（HBV）.Methods The clinic data of 156 ACLF patients caused by HBV were retrospectively analyzed,to add up the inducements and prognosis in order to investigate the effect of different inducements on prognosis by Logistic regression analysis.Results The most common inducement of ACLF caused by HBV was HBV activation（60.26%）.Multiple factor Logistic regression analysis demonstrated that prognosis was significantly related to HBV mutation,drug withdrawal at random（P0.05）,the odd ratio（OR）of them was 7.858,2.745,respectively.Conclusion HBV mutation and drug withdrawal at random are the independent risk factors,rational use antiviral drugs to control HBV activation and avoid inducements as far as possible could decrease the occurrence of ACLF and improve prognosis.