中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2013年
7期
404-407
,共4页
林明华%高海兵%潘晨%周锐%林太杰%王香梅%李孝楼
林明華%高海兵%潘晨%週銳%林太傑%王香梅%李孝樓
림명화%고해병%반신%주예%림태걸%왕향매%리효루
肝炎,乙型%肝功能衰竭%肝性脑病%危险因素
肝炎,乙型%肝功能衰竭%肝性腦病%危險因素
간염,을형%간공능쇠갈%간성뇌병%위험인소
Hepatitis B%Liver failure%Hepatic encephalopathy%Risk factors
目的 探讨HBV相关慢加急性肝功能衰竭(ACLF)中期并发肝性脑病的危险因素,便于临床预防干预.方法 287例HBV相关ACLF中期患者作为研究对象,应用Logistic回归分析对年龄、性别、糖尿病、肝硬化、上消化道出血、自发性细菌性腹膜炎、肺部感染、Alb、球蛋白、TBil、ALT、AST、γ-GT、碱性磷酸酶、总胆固醇、胆碱酯酶、血Cr、PTA、国际标准化比值、甲胎蛋白、HBVDNA载量、血钾、血钠、WBC、PLT等临床指标进行单因素和多因素分析.结果 多因素Logistic回归分析显示,血清钾(B=-2.006,P=0.000,OR=0.135,95％CI:0.051～0.353)、血清钠(B=-0.096,P=0.014,OR=0.908,95％CI:0.841～0.981)、肺部感染(B=1.648,P=0.018,OR=5.199,95％CI:1.326～20.386)、甲胎蛋白(B=-0.010,P=0.024,OR=0.990,95％CI:0.982～0.999)与肝功能衰竭患者发生肝性脑病相关.结论 低钾血症、低钠血症、肺部感染、甲胎蛋白不升高是HBV相关ACLF中期患者并发肝性脑病的独立危险因素.
目的 探討HBV相關慢加急性肝功能衰竭(ACLF)中期併髮肝性腦病的危險因素,便于臨床預防榦預.方法 287例HBV相關ACLF中期患者作為研究對象,應用Logistic迴歸分析對年齡、性彆、糖尿病、肝硬化、上消化道齣血、自髮性細菌性腹膜炎、肺部感染、Alb、毬蛋白、TBil、ALT、AST、γ-GT、堿性燐痠酶、總膽固醇、膽堿酯酶、血Cr、PTA、國際標準化比值、甲胎蛋白、HBVDNA載量、血鉀、血鈉、WBC、PLT等臨床指標進行單因素和多因素分析.結果 多因素Logistic迴歸分析顯示,血清鉀(B=-2.006,P=0.000,OR=0.135,95％CI:0.051～0.353)、血清鈉(B=-0.096,P=0.014,OR=0.908,95％CI:0.841～0.981)、肺部感染(B=1.648,P=0.018,OR=5.199,95％CI:1.326～20.386)、甲胎蛋白(B=-0.010,P=0.024,OR=0.990,95％CI:0.982～0.999)與肝功能衰竭患者髮生肝性腦病相關.結論 低鉀血癥、低鈉血癥、肺部感染、甲胎蛋白不升高是HBV相關ACLF中期患者併髮肝性腦病的獨立危險因素.
목적 탐토HBV상관만가급성간공능쇠갈(ACLF)중기병발간성뇌병적위험인소,편우림상예방간예.방법 287례HBV상관ACLF중기환자작위연구대상,응용Logistic회귀분석대년령、성별、당뇨병、간경화、상소화도출혈、자발성세균성복막염、폐부감염、Alb、구단백、TBil、ALT、AST、γ-GT、감성린산매、총담고순、담감지매、혈Cr、PTA、국제표준화비치、갑태단백、HBVDNA재량、혈갑、혈납、WBC、PLT등림상지표진행단인소화다인소분석.결과 다인소Logistic회귀분석현시,혈청갑(B=-2.006,P=0.000,OR=0.135,95％CI:0.051～0.353)、혈청납(B=-0.096,P=0.014,OR=0.908,95％CI:0.841～0.981)、폐부감염(B=1.648,P=0.018,OR=5.199,95％CI:1.326～20.386)、갑태단백(B=-0.010,P=0.024,OR=0.990,95％CI:0.982～0.999)여간공능쇠갈환자발생간성뇌병상관.결론 저갑혈증、저납혈증、폐부감염、갑태단백불승고시HBV상관ACLF중기환자병발간성뇌병적독립위험인소.
Objective To investigate the risk factors for the presence of hepatic encephalopathy in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) in the midphase.Methods A total of 287 patients with HBV-related ACLF in the mid-phase were recruited.Clinical data (age,gender,diabetes,liver cirrhosis,upper gastrointestinal hemorrhage,spontaneous bacterial peritonitis,and pulmonary infection) and laboratory findings [albumin,globulin,total bilirubin (TBil),alanine transaminase (ALT),aspartate aminotransferase (AST),glutamyl transpeptidase (γ-GT),alkaline phosphatase,total cholesterol,cholinesterase,creatinine,prothrombin activity (PTA),international normalized ratio,alpha-fetoprotein (AFP),loads of HBV DNA,serum potassium,serum sodium,white blood cell,and platelet count] were included as potential risk factors and analyzed with univariate and multivariate Logistic regressions.Results Multiple Logistic regression analysis indicated that serum potassium(B =-2.006,P =0.000,OR =0.135,95％CI:0.051-0.353),serum sodium(B=-0.096,P=0.014,OR=0.908,95％CI..0.841-0.981),pulmonary infection (B =1.648,P =0.018,OR =5.199,95 ％ CI:1.326-20.386),AFP (B=-0.010,P =0.024,OR =0.990,95％ CI:0.982-0.999) were correlated with hepatic encephalopathy.Conclusion Hypokalemia,hyponatremia,pulmonary infection and low levels of AFP are independent risk factors of the presence of hepatic encephalopathy in patients with HBV-related ACLF in the mid-phase.
