乙型肝炎相关性慢加(亚)急性肝衰竭与全身炎症反应综合征的临床分析

Clinical analysis of hepatitis B related acute-on-chronic liver failure and systemic inflammatory response syndrome

目的:了解全身炎症反应综合征(SIRS)在乙型肝炎相关性慢加(亚)急性肝衰竭(HBV-ACLF)患者中的发生率,及其对病情转归的影响。方法:采用回顾性分析法分析158例HBV-ACLF患者SIRS的发生率,分析两组患者一般情况、并发症、实验室检查以及病情转归的差异。结果:HBV-ACLF患者SIRS发生率为45.6%;基础疾病为乙型肝炎肝硬化的患者SIRS发生率明显高于慢性乙型肝炎患者(P<0.05);ACLF中期及晚期患者SIRS发生率明显高于早期患者(P<0.05);HBV-ACLF合并SIRS的主要原因为感染;SIRS的患者出现并发症的发生率明显多于无SIRS患者(P<0.05);出现SIRS患者的TBil、Cr、INR高于无SIRS患者(P<0.05),而PTA低于无SIRS发生的者(P<0.05)。结论:HBV-ACLF患者合并SIRS可进一步加重肝损害,导致患者的死亡率增加。

Objective： To investigate the incidence of SIRS in patients with HBV-ACLF. Methods： The incidence of SIRS in 158 patients with HBV-ACLF was analyzed by retrospective analysis. The general condition,complication,laboratory examination and the difference of disease outcome were analyzed. Results： The incidence of SIRS in patients with HBV-ACLF was 45. 6%. The incidence of SIRS in patients with underlying liver cirrhosis was significantly higher than that in patients with chronic hepatitis B（ P 0. 05）. The incidence of SIRS in ACLF patients was significantly higher than that in early patients（ P 0. 05）. The incidence of complications,levels of TBIL,Cr and INR in SIRS group were all significantly higher than that in non-SIRS group（ P 0. 05）. while,level of PTA was lower than that in non-SIRS group（ P 0. 05）. Conclusion： HBV-ACLF patients combined with SIRS could further aggravate liver injury,the mortality rate of patients increased dramatically.