急性乙型肝炎伴严重高胆红素血症的危险因素

Risk factors of acute hepatitis B complicated with serious hyperbilirubinemia

目的探析急性乙型肝炎伴严重高胆红素血症(血清总胆红素>171μmol/L)的发病情况及其相关的危险因素。方法调查并分析了济南市传染病医院618例住院急性乙型肝炎患者人口资料、血生化、乙肝病毒血清学及病毒学指标。结果 618例患者中,549例(88.5%)伴有胆红素升高,其中202例(32.7%)血清总胆红素大于171μmol/L。单因素分析显示,有饮酒史及发热、乏力、纳差症状且较年长的患者更易伴发严重高胆红素血症(P<0.001)。多因素Logistic回归显示,年龄、饮酒史、发热、乏力、纳差是急性乙型肝炎伴严重高胆红素血症的独立危险因素。结论年龄、饮酒史、发热、乏力、纳差是急性乙型肝炎伴严重高胆红素血症的独立危险因素。

Objective To investigate the prevalence and risk factors of acute hepatitis B complicated with serious hyperbilirubinemia（serum total bilirubin level 171 μmol/L）.Methods Demographic data,biochemical parameters,serology and virology arguments of 618 patients with acute hepatitis B in Jinan Infectious Disease Hospital were analyzed.Results Elevated bilirubin levels were detected in 549 patients（88.5%）,among which bilirubin levels in 202 cases（32.7%）were higher than 171 μmol/L.Univariate analysis showed that old patients with alcohol abuse,fever,fatigue and bad appetite were more likely to suffer from serious hyperbilirubinemia（P0.001）.Multivariate logistic regression analysis showed that old age,alcohol abuse,fever,fatigue and bad appetite were independent risk factors for serious hyperbilirubinemia in acute hepatitis B.Conclusion Old age,alcohol abuse,fever,fatigue and bad appetite are independent risk factors for serious hyperbilirubinemia in acute hepatitis B.