家族聚集性HBV相关慢加急性肝衰竭患者临床特点分析

Clinical characteristics of hepatitis B virus-related acute-on-chronic liver failure patients with familial aggregation

目的 分析家族聚集性乙型肝炎患者发生慢加急性肝衰竭的临床特点,为指导防治乙型肝炎患者相关慢加急性肝衰竭提供依据.方法 选取解放军三○二医院住院的HBV相关慢加急性肝衰竭患者275例,根据其流行病学特点,分成家族聚集性及非家族聚集性组,对比两组临床及检验指标特点.结果 275例患者中有家族聚集性患者为93例（33.82％）,与慢性乙型肝炎患者中家族聚集性比例38.3％差异无统计学意义.在HBV相关慢加急性肝衰竭患者中两组平均年龄分别为45.98岁及43.61岁（P＞0.05）；有家族聚集性患者中肝硬化比例更高（73.91％vs 58.24％,P＜0.05）；转归稍差（62.37％ vs 70.33％）,但差异无统计学意义.两组患者胆红素最高值及凝血酶原活动度最低值均无统计学差异,但丙氨酸转移酶差异有统计学意义,非家族聚集性组比有家族聚集性组ALT更高,平均为407.80U/L及256.45U/L（P＜0.05）.结论 在慢性HBV感染患者中,慢加急性肝衰竭的发生率与是否具有家族聚集性无明显相关,但家族聚集性HBV相关慢加急性肝衰竭患者中肝硬化比例更高.

Objective To study the clinical characteristics of hepatitis B virus-related acute-on-chronic liver failure patients with familial aggregation.Methods 275 patients with hepatitis B virus - related acute-on-chronic liver failure were investigated.The patients were divided into familial aggregation and nonfamilial aggregation group basis on their epidemiological features.Clinical data and biochemical indicators between the two groups were analyzed statistically.Results 93 of 275 patients（ 33.82% ） case were family aggregation.There was no significant difference compared with chronic hepatitis B patients（ 38.3% ）.The mean age of the two groups was 45.98 and 43.61 years old,respectively （P 〉 0.05 ）.The rates of liver cirrhosis in family aggregation group were significant higher than non - familial aggregation group（ 73.91% vs 58.24%,p 〈 0.05 ）.Serum total （TBil） and prothrombin activities （ PTA ） were no significant difference between the two groups,but ALT level in familial aggregation group was much higher （407.80U/L vs 256.45 U/L,P0.05 ）.Conclusion Familial aggregation were not related to acute-on-chronic liver failure in chronic HBV hepatitis patients. But the rate of liver cirrhosis were higher in patients with familial aggregation.