中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2008年
8期
516-519
,共4页
吴赤红%田庚善%王勤环%于岩岩%窦永青%徐小元
吳赤紅%田庚善%王勤環%于巖巖%竇永青%徐小元
오적홍%전경선%왕근배%우암암%두영청%서소원
肝硬化%预后%腹水
肝硬化%預後%腹水
간경화%예후%복수
Liver cirrhosis%Prognosis%Ascites
目的 分析慢性丙型肝炎肝硬化患者第1次出现并发症后的临床特点及预后.方法 对89例失代偿性丙肝肝硬化患者进行5年的随访观察,并对临床失代偿发生因素进行单因素和多因素分析.结果 第1次出现并发症时,腹水最常出现占40例(44.9%),其次上消化道出血21例(23.6%),自发性腹膜炎18例(20.2%),肝性脑病10例(11.2%).在平均62个月(60～66个月)随访过程中,42例患者出现腹水(47.2%),16例出现自发性腹膜炎(18.0%),14例上消化道出血(15.7%),7例肝性脑病(7.9%),10例肝癌(11.2%).肝癌是患者的主要死亡原因(11.2%),每年的病死率4.5%.肝性脑病、腹水、消化道出血、自发性腹膜炎为第1个失代偿期并发症者5年的生存率分别为64.5%、85.0%、75.0%、83.3%,多因素回归分析结果显示食管胃底静脉曲张和胆红素为临床失代偿发生的惟一独立预测因素.结论 慢性丙型肝炎肝硬化是一个缓慢进行性疾病,肝癌是其重要并发症,并发症的出现对预后有影响,这些结果将有利于探讨失代偿期丙肝肝硬化患者的自然病程和临床预后.
目的 分析慢性丙型肝炎肝硬化患者第1次齣現併髮癥後的臨床特點及預後.方法 對89例失代償性丙肝肝硬化患者進行5年的隨訪觀察,併對臨床失代償髮生因素進行單因素和多因素分析.結果 第1次齣現併髮癥時,腹水最常齣現佔40例(44.9%),其次上消化道齣血21例(23.6%),自髮性腹膜炎18例(20.2%),肝性腦病10例(11.2%).在平均62箇月(60～66箇月)隨訪過程中,42例患者齣現腹水(47.2%),16例齣現自髮性腹膜炎(18.0%),14例上消化道齣血(15.7%),7例肝性腦病(7.9%),10例肝癌(11.2%).肝癌是患者的主要死亡原因(11.2%),每年的病死率4.5%.肝性腦病、腹水、消化道齣血、自髮性腹膜炎為第1箇失代償期併髮癥者5年的生存率分彆為64.5%、85.0%、75.0%、83.3%,多因素迴歸分析結果顯示食管胃底靜脈麯張和膽紅素為臨床失代償髮生的惟一獨立預測因素.結論 慢性丙型肝炎肝硬化是一箇緩慢進行性疾病,肝癌是其重要併髮癥,併髮癥的齣現對預後有影響,這些結果將有利于探討失代償期丙肝肝硬化患者的自然病程和臨床預後.
목적 분석만성병형간염간경화환자제1차출현병발증후적림상특점급예후.방법 대89례실대상성병간간경화환자진행5년적수방관찰,병대림상실대상발생인소진행단인소화다인소분석.결과 제1차출현병발증시,복수최상출현점40례(44.9%),기차상소화도출혈21례(23.6%),자발성복막염18례(20.2%),간성뇌병10례(11.2%).재평균62개월(60～66개월)수방과정중,42례환자출현복수(47.2%),16례출현자발성복막염(18.0%),14례상소화도출혈(15.7%),7례간성뇌병(7.9%),10례간암(11.2%).간암시환자적주요사망원인(11.2%),매년적병사솔4.5%.간성뇌병、복수、소화도출혈、자발성복막염위제1개실대상기병발증자5년적생존솔분별위64.5%、85.0%、75.0%、83.3%,다인소회귀분석결과현시식관위저정맥곡장화담홍소위림상실대상발생적유일독립예측인소.결론 만성병형간염간경화시일개완만진행성질병,간암시기중요병발증,병발증적출현대예후유영향,저사결과장유리우탐토실대상기병간간경화환자적자연병정화림상예후.
Objectlve To study the clinical features and prognosis of hepatitis C virus (HCV)-related cirrhosis after the first occurrence of complications.Methods The clinical data of 89 decompensated HCV-related cirrhosis patients were analyzed.Univariate and multivariate analyses of the factors influencing the clinical decompensation were conducted.Results Ascites was the most frequent first decompensation (44.9％),followed by upper gastrointestinal bleeding (23.6％),and serf-originated peritonitis (20.2％),and hepatic encephalopathy (11.2％).During the follow-up of 62 months (60-66 months) ascites was the most frequent first decompensation (47.2％),followed by self-originated peritonitis (18.0％),upper gastrointestinal bleeding(15.7％),and hepatic encephalopathy(7.9％).The 5-year survival rates after of the patients with hepatic encephalopathy,ascites,upper gastrointestinal bleeding and self-originated peritonitis as the first decompensated complications were 64.5％,85.0％,75.0％,and 83.3％ respectively.Multivariate regression analysis showed that esophageal and gastro varices and billirubin were independently correlated with survival.Conclusion Hepatitis C iS a slowly progressing disease.Decompensation occurring in hepatitis C is significantly correlated with survival.
