外周血血红蛋白含量对乙型肝炎慢加亚急性肝衰竭患者预后的评估作用

Clinical significance of peripheral blood hemoglobin in patients with subacute-on-chronic liver failure

目的:探讨乙型肝炎慢加亚急性肝衰竭(SACLF)患者外周血血红蛋白(Hb)含量与预后的相关性。方法:分析我院92例乙型肝炎SACLF患者临床资料,并根据预后分为死亡组与存活组,分别检测入院第1天、第14天患者外周血Hb、总胆红素(TBil)、肌酐(Cr)、凝血酶原国际标准化值(INR)等指标,同时计算出终末期肝病模型(MELD)的分值,分析Hb与TBil、MELD两者的相关性。结果:SACLF死亡组与存活组患者入院时在Hb方面比较差异无显著性意义;死亡组患者在第14天Hb含量明显低于存活组(P<0.05);两组患者在入院后第1天、第14天Hb差值[Hb(d1-d14)]比较,差异具有显著性意义(P<0.05);92例SACLF患者Hb均值为(113.21±22.59)g/L,TBil均值为(342.24±197.22)μmol/L,MELD均值为23.07±9.14,Hb与TBil、MELD均呈负相关(r=-0.508,r=-0.538,P<0.05,P<0.05)。结论:SACLF患者外周血Hb下降提示预后不佳,可以作为评估肝衰竭预后的指标之一。

Objective：To study the change of blood hemoglobin（Hb） in patients with subacute-on-chronic liver failure（SACLF）,and investigate its clinical significance.Methods：Ninety-two SACLF patients were devided into the survival group and the death group,blood hemoglobin（Hb）,total bilirubiientsn（TBil）,creatinine（Cr）,prothrombin time international normalized ratio（INR） were detected on the first day,14th day.Correlation between Hb and total bilirubin（TBil）,model for end-stage liver disease（MELD） scores were analyzed.Results：There was no significant difference of the Hb level between the death group and the survival group on the first day,but on day 14th the death group′s Hb levels was significantly lower than survival groups′（P0.05）;There was statistical difference（P0.05）of Hb level′s D-value（first day-14th day）between the two groups;there was a negative correlation between Hb（113.21±22.59） g/L and TBil（342.24±197.22） μmol/L,MELD（23.07±9.14）（r =-0.508,r =-0.538,P0.05,P0.05）.Conclusion：Hb declined gradually during SACLF predicted poor prognosis,which suggested that Hb maybe a useful index to predict the prognosis of patients with SACLF.