慢加急性乙型肝炎肝衰竭并发症与预后的关系研究

Relationship between complications and prognosis of acute-on-chronic hepatitis B liver failure

目的探讨慢加急性乙型肝炎肝衰竭并发症与预后的关系,为临床上预后判断和有效治疗提供重要依据。方法回顾性分析2002年7月至2004年12月北京地坛医院收治的206例慢加急性乙型肝炎肝衰竭患者。结果慢加急性乙型肝炎肝衰竭最常见的并发症是肝性脑病(HE)、肝肾综合征(HRS)、消化道出血(GB)和继发细菌感染(SBI),HE组与无HE组好转率分别是6.9%和55.5%,HRS组与无HRS组好转率分别是0和58.9%,GB组与无GB组好转率分别是9.7%和40%,SBI组与无SBI组好转率分别是27.6%和54.1%,以上各组比较P值均≤0.001,差异有统计学意义。结论慢加急性乙型肝炎肝衰竭并发症的出现预后差,临床上预防、早期诊断和有效治疗并发症,能有效改善预后,应引起临床工作者更大重视和关注。

Objective To discuss the relationship between complications and prognosis of acute-on-chronic hepatitis B liver failure,and provide a reference for clinically effective treatment.Method 206 patients with acute-on-chronic hepatitis B liver failure treated in Beijing Ditan Hospital from July,2002 to December,2004 were analyzed retrospectively.Result The most common complications of acute-on-chronic hepatitis B liver failure were Hepatic encephalopathy,Hepatorenal syndrome,Gastrointestinal bleeding and Secondary bacteria infection.The improvement rate of patients was 6.9% in HE group,0% in HRS group,9.7% in GB group,and 27.6% in SBI group,while it was 55.5%,58.9%,40% and 54.1% in non-HE,non-HRS,non-GB and non-SBI group,respectively.There was statistical significance in the differences between the patients with any kind of complications and those without complications（P≤0.001）.Conclusion Effective treatment of complications of acute-on-chronic hepatitis B liver failure and reduction of occurring rate of the complications are the key to reduce the case-fatality rate of this disease.