贵州医科大学学报

2018, v.43;No.216(09) 1088-1091

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乙肝合并酒精性肝病患者失代偿期肝硬化并发肝衰竭的相关危险因素
Regression Analysis of Risk Factors of Liver Failure of Decompensated Cirrhotic Patients with Hepatitis B Complicated with Alcoholic Liver Disease

韦美华;祖亚洁;
WEI Meihua;ZU Yajie;Department of Gastroenterology,263 Clinical Department of Army General Hospital PLA;

摘要(Abstract):

目的:分析乙型肝炎病毒(HBV)合并酒精性肝病(ALD)患者失代偿期肝硬化并发肝衰竭的相关危险因素。方法:收集HBV合并ALD的失代偿期肝硬化患者78例,将31例并发肝衰竭患者作为观察组,其余47例作为对照组;观察两组患者的肝功能Child-Pugh分级、腹水分级、食管胃底静脉曲张程度、并发食管胃底静脉曲张破裂出血、肝性脑病、肝肾综合征及细菌感染发生率,记录两组患者的饮酒年限、饮酒量血总胆红素(TBil),检测血谷丙转氨酶(ALT)、血氨、白蛋白(ALB)、肌酐、血钠、HBV-DNA定量及凝血酶原活动度(PTA),评估2组患者并发肝衰竭的相关危险因素、并进行Logistic回归分析。结果:观察组患者肝功能Child-Pugh分级、腹水分级、食管胃底静脉曲张程度、并发食管胃底静脉曲张破裂出血、肝性脑病、肝肾综合征、细菌感染发生率均高于对照组,差异有统计学意义(P <0. 05);观察组患者饮酒时间、饮酒量、血TBil、血氨、肌酐、血钠、HBV-DNA高于对照组,观察组患者血钠和PTA低于对照组,差异有统计学意义(P <0. 05)。结论:肝功能Child-Pugh分级、腹水、食管胃底静脉曲张、并发食管胃底静脉曲张破裂出血、肝性脑病、肝肾综合征、细菌感染发生率及患者及饮酒时间、饮酒量等是HBV合并ALD患者失代偿期肝硬化并发肝衰竭的相关危险因素。
Objective: To analyze the risk factors of liver failure of decompensated cirrhotic patients with hepatitis B virus infection( HBV) complicated with alcoholic liver disease( ALD),so as to provide the basis for early clinical prevention and treatment. Methods: 78 decompensated cirrhosis patients with HBV infection complicated with ALD were selected in our hospital from March 2016 to October 2017,of which 31 cases complicated by liver failure were chosen as the study group,and the remaining 47 cases as the control group. The related risk factors associated with liver failure of the patients were detected by Logistic regression analysis. Results: The incidence of child-pugh class( Grade C),ascites( Grade 3),esophageal varices( severe),gastroesophageal varices bleeding,hepatic encephalopathy,hepatorenal syndrome and bacterial infection of the study group were higher than those in the control group. The difference was statistically significant( P < 0. 05). The duration of drinking,alcohol consumption,serum Tbil,ammonia,creatinine,and serum Na +,HBV-DNA quantification of the study group were higher than those in the control group respectively,while serum sodium and PTA of the study group were lower than those of the control group,and the difference was statistically significant( P < 0. 05). Conclusion: The risk factors associated with liver failure in decompensated cirrhotic patients with HBV and ALD were correlated with child-pugh class( Grade C),ascites( Grade 3),esophageal varices( severe),gastroesophageal varices bleeding,hepatic encephalopathy,hepatorenal syndrome and bacterial infection,the duration of drinking,alcohol consumption,serum Tbil,ammonia,creatinine,serum Na +,HBV-DNA quantification and PTA.

关键词(KeyWords): 肝炎病毒,乙型;肝炎,酒精性;肝硬化;肝功能衰竭;危险因素;回归分析
hepatitis B virus;hepatitis,alcoholic;liver cirrhosis;liver failure;risk factors;regression analysis

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基金项目(Foundation): 国家自然科学基金青年科学基金项目(81071356)

作者(Author): 韦美华;祖亚洁;
WEI Meihua;ZU Yajie;Department of Gastroenterology,263 Clinical Department of Army General Hospital PLA;

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