失代偿期肝硬化合并肾损害患者危险因素分析

Risk factors of decompensated cirrhosis complicated with renal damage

目的分析失代偿期肝硬化合并肾损害危险因素。方法选择2010年1月至2020年12月年于宁夏医科大学总医院住院治疗的439例失代偿期肝硬化患者,根据其是否发生肾损害分为肾损害组和无肾损害组。记录患者一般资料、合并症及并发症资料、CTP分级等,单因素及多因素分析失代偿期肝硬化合并肾损害患者的危险因素。结果单因素分析显示高龄、合并糖尿病和(或)高血压、并发低钠血症、肝性脑病(HE)及自发性腹膜炎(SBP)、慢加急性肝衰竭(ACLF),门静脉主干内径(PVD)增宽、CTP分级较高的患者肾损害发生率更高(P<0.05)。多因素分析显示高龄、合并高血压和(或)糖尿病、低钠血症、PVD增宽、ACLF及CTP分级C级是肝硬化合并肾损害的独立危险因素(P<0.05)。结论失代偿期肝硬化患者容易发生肾损害,年龄、合并存在高血压和(或)糖尿病、PVD增宽、低钠血症、ACLF及CTP分级C级是失代偿期肝硬化患者发生肾损害的独立危险因素。

Objective To analyze the clinical characteristics of patients with decompensated cirrhosis and renal damage,and to explore the risk factors of renal damage complicated by decompensated cirrhosis.Methods A total of 439 patients with decompensated cirrhosis who were hospitalized in the General Hospital of Ningxia Medical University from January2010 to December 2020 were selected and divided into renal damage group and non-renal damage group according to whether they had kidney damage.The general data of patients,comorbidities and complications,CTP grade,etc.were recorded,and the clinical characteristics of patients with decompensated cirrhosis combined with renal damage were analyzed in one factor and multiple factors.Results Univariate analysis showed that patients with advanced age,diabetes and/or hypertension,hyponatremia,hepatic encephalopathy(HE)and spontaneous peritonitis(SBP),chronic acute liver failure(ACLF),widened portal trunk inner diameter(PVD),and higher CTP grade had a higher incidence of renal damage(P<0.05).Multivariate analysis showed that advanced age,hypertension and/or diabetes,hyponatremia,increased PVD,ACLF and CTP grade C were independent risk factors for cirrhosis and renal impairment(P<0.05).Conclusion Patients with decompensated cirrhosis are prone to kidney damage,and age,hypertension and/or diabetes,increased PVD,hyponatremia,ACLF and CTP grade C are independent risk factors for kidney damage in patients with decompensated cirrhosis.