失代偿期乙型肝炎后肝硬化病人营养状况与预后关系的研究

The relationship between nutritional status and prognosis of patients with decompensated hepatitis B virus-related liver cirrhosis

目的:分析失代偿期乙型肝炎后肝硬化病人营养状况以及与预后的关系。方法:将104例失代偿期乙型肝炎后肝硬化病人,根据营养风险筛查2002分为营养风险组和非营养风险组,对比分析两组病人测量营养参数、实验室指标和肝功能Child-Pugh分级,并随访12个月,比较两组6个月内和12个月内并发症发生率和病死率。结果:营养风险组的体重指数、三头肌皮褶厚度、上臂肌围、血清白蛋白、前白蛋白、总胆固醇、甘油三酯和血红蛋白显著低于非营养风险组,肝功能child-Pugh分级高于非营养风险组,差异均存在统计学意义(P<0.05)。营养风险组在6个月和12个月内的消化道出血、自发性腹膜炎,12个月内的肝性脑病、门静脉血栓形成发生率显著升高,差异均有统计学意义(P<0.05)。营养风险组6个月和12个月内病死率显著升高,存在统计学意义(P<0.05)。结论:存在营养风险的失代偿期乙型肝炎后肝硬化病人并发症及病死率显著升高,需及时进行营养干预。

Objective: To analyze the relationship between nutritional status and prognosis of patients with decompensated hepatitis B virus-related liver cirrhosis. Methods: One-hundred and four patients with decompensated hepatitis B virus-related liver cirrhosis, according to the Nutritional Risk Screening 2002(NRS-2002) score, were divided into malnutrition risk group and non-malnutrition risk group. Anthropometry parameters, biochemistry parameters, ChildPugh score were compared between the two groups. Based on 12-month follow-up visit, incidence of complications and mortality within 6 months and 12 months were also compared. Results: The malnutrition risk group had lower levels of body mass index, triceps skinfold thickness, arm muscle circumference, albumin, pre-albumin, total cholesterol, triglyceride, hemoglobin and higher Child-Pugh score(all P < 0.05). Compared with the non-malnutrition risk group, the malnutrition risk group had a significantly lower incidence of gastrointestinal bleeding and spontaneous peritonitis within 6 months and 12 months, hepatic encephalopathy and portal thrombosis within 12 months(all P < 0.05). Conclusion:Complications and mortality of decompensated hepatitis B virus-related liver cirrhosis patients with malnutrition risk were significantly increased and nutritional intervention is required.