CAJ | 학술논문

目的：旨在探讨影响严重肝炎活动预后的因素。方法应用Logistic回归分析69例严重肝炎活动患者，探讨可能与进展成肝衰竭相关的临床和病毒学指标，包括 HBV基因型、PC（G1896A）及BCP（A1762T／G1764A）变异；筛选出独立预测因素。结果严重活动性肝炎患者中，33例（47．8％）进展成肝衰竭。多因素分析筛选出总胆红素升高（TB＞256μmol／dL ，P＝0．008）及凝血功能异常（PTA＜40％， P＜0．001）是严重肝炎活动进展为肝衰竭的危险因素。 HBeAg 阴性（P＝0．065）、PC变异（P＝0．090）与病情恶化有一定相关性。结论血清总胆红素水平、凝血功能、HBeAg状态及PC变异在预测HBV相关的严重肝炎活动进展为肝衰竭中有预测价值。
목적：지재탐토영향엄중간염활동예후적인소。방법응용Logistic회귀분석69례엄중간염활동환자，탐토가능여진전성간쇠갈상관적림상화병독학지표，포괄 HBV기인형、PC（G1896A）급BCP（A1762T／G1764A）변이；사선출독립예측인소。결과엄중활동성간염환자중，33례（47．8％）진전성간쇠갈。다인소분석사선출총담홍소승고（TB＞256μmol／dL ，P＝0．008）급응혈공능이상（PTA＜40％， P＜0．001）시엄중간염활동진전위간쇠갈적위험인소。 HBeAg 음성（P＝0．065）、PC변이（P＝0．090）여병정악화유일정상관성。결론혈청총담홍소수평、응혈공능、HBeAg상태급PC변이재예측HBV상관적엄중간염활동진전위간쇠갈중유예측개치。
ABSTRACT:In this study ,we elucidated the predictors of progression to liver failure during severe acute exacerbation .We analyzed 69 consecutive patients with severe acute exacerbation of chronic hepatitis B for clinical outcome and factors that influ‐enced the development of liver failure ,including viral genotype ,PC (G1896A) and BCP (A1762T/G1764A) mutants .Thirty‐three (47 .8% ) severe acute exacerbation patients progressed to liver failure .Multivariate analysis identified serum bilirubin (TB>256 μmol/dL ,P=0 .008) and prothrombin activity (PTA<40% ,P<0 .001) as significant determinants of progression to liver failure .HBeAg negativity (P=0 .065) and PC mutant (P=0 .090) were associated with the progression to hepatic de‐compensation .Serum total bilirubin ,prothrombin activities ,HBeAg status and PC mutant were predictors of clinical outcome in patients with severe acute exacerbation of chronic hepatitis B .