缺氧性肝炎的临床特征及预后因素分析

Analysis of Clinical Characteristics and Risk Factors of Hypoxic Hepatitis

分析缺氧性肝炎患者的临床特征及影响预后的危险因素。收集缺氧性肝炎患者41例,其中死亡18例(死亡组),生存23例(存活组),病死率为43.9%,分析患者临床资料。结果显示:缺氧性肝炎患者平均年龄(74.7±12.5)岁,以70岁~89岁患者居多(占73.2%),并发于感染性休克者占70.7%;死亡组患者中合并冠心病及糖尿病的百分数均明显高于生存组,差异有统计学意义(P<0.05);死亡组患者AST、LDH、INR、Cre、Bun、乳酸水平分别明显高于生存组,差异有统计学意义(P<0.05),死亡组患者的pH、HCO_3^-水平分别明显低于生存组,差异有统计学意义(P<0.05),死亡组患者中合并酸中毒者的百分数明显高于生存组,差异有统计学意义(P<0.05);合并冠心病、糖尿病是影响缺氧性肝炎预后的危险因素(OR值分别为6.44、4.59,P<0.05)。可见缺氧性肝炎多见于老年患者,常并发于感染性休克,病死率较高,冠心病、糖尿病是影响其预后的危险因素。

To analyze the clinical characteristics and risk factors of patients with hypoxic hepatitis.41 patients with hypoxic hepatitis were included.The rate of in-hospital mortality was 43.9%（18nonsurvivors and 23survivors）.Clinical date of all patients were recorded and analyzed.The mean age was 74.7 ± 12.5 years old.The majority（73.2%）were between 70-89 years old.The most common cause was septic shock（70.7%）.The percentage of the nonsurvivors with coronary heart disease and diabetes mellitus was significantly higher than that of the survivors（P〈0.05）.The serum levels of AST,LDH,INR,Cre,Bun and lactic acid were significantly higher in nonsurvivors than that of the survivors（P〈0.05）.The arterial blood levels of pH and HCO3^- were significantly lower in survivors than that of the nonsurvivors（P〈0.05）.Acidosis was more common in the dead cases than that of in the survisors（P〈0.05）.Risk factors of mortality were coronary heart disease（Odds ratio=6.44,P=0.044）,and diabetes mellitus（Odds ratio =4.59,P=0.047）.Hypoxic hepatitis is more common in elderly patients,and frequently accompanied by septic shock,with high mortality.Risk factors for increased mortality are coronary heart disease and diabetes mellitus.