外周血中皮质醇水平与老年乙肝病毒相关慢加急性肝衰竭患者病情和预后的关系

发布时间：2018-03-10 14:07

本文选题：皮质醇　切入点：乙肝病毒　出处：《中国老年学杂志》2015年04期 　论文类型：期刊论文

【摘要】：目的探讨外周血中皮质醇水平和乙肝病毒相关慢加急性肝衰竭老年患者病情和预后的关系。方法共纳入100例入住该院诊断为乙肝病毒相关慢加急性肝衰竭老年患者,根据其病情分为早期、中期、晚期三组,同时选择40例重度慢性乙型肝炎患者,空腹抽取静脉血检测外周血中皮质醇水平及相关生化指标,并随访观察外周血皮质醇水平变化。结果 100例诊断为乙肝病毒相关慢加急性肝衰竭老年患者中,早期肝衰竭46例,中期32例,晚期22例。四组患者皮质醇、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)水平比较差异有统计学意义(P0.05);随肝衰竭程度的增加,皮质醇水平逐渐降低,ALT、AST、TBil水平逐渐上升,其余指标比较差异不明显(P0.05)。皮质醇水平与ALT、AST、TBil水平呈负相关关系(P0.05),与ALB、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、HBV-DNA无相关性。100例乙肝病毒相关慢加急性肝衰竭老年患者存活45例,死亡55例,诊断第1、7、14、21、30天存活组皮质醇水平均高于死亡组(P0.05);且随时间发展,存活组皮质醇水平呈上升趋势,死亡组呈下降趋势。结论乙肝病毒相关慢加急性肝衰竭患者皮质醇水平随病情加重而下降,其水平可作为临床预测患者生存预后的指标之一,值得临床推广。
[Abstract]:Objective to investigate the relationship between cortisol level in peripheral blood and the condition and prognosis of elderly patients with chronic hepatitis B virus associated chronic and acute hepatic failure. Methods 100 elderly patients with chronic hepatitis B virus associated with acute liver failure were included in this study. According to their condition, they were divided into three groups: early, middle and late stage, and 40 patients with severe chronic hepatitis B were selected at the same time. Venous blood was taken on an empty stomach to detect the level of cortisol in peripheral blood and related biochemical indexes. Results among 100 elderly patients with chronic and acute hepatic failure associated with hepatitis B virus, 46 cases were early hepatic failure, 32 cases were middle stage, 22 cases were late stage. The levels of alanine aminotransferase (alt), alanine aminotransferase (AST), total bilirubin (TBill) were significantly different (P 0.05), and the level of cortisol gradually decreased with the increase of liver failure. There was no significant difference in other indexes (P 0.05). There was a negative correlation between cortisol level and alt ASTTBil level. There was no correlation between cortisol level and ALB, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-Cn), total cholesterol TCU, triglyceride TGHBV-DNA. 100 cases of hepatitis B virus. 45 elderly patients with associated chronic and acute liver failure survived, The level of cortisol in the survival group was higher than that in the dead group on the 30th day after diagnosis, and the level of cortisol in the surviving group increased with the development of time. Conclusion the level of cortisol in patients with chronic hepatitis B virus associated with acute hepatic failure decreases with the exacerbation of the disease, which can be used as one of the clinical predictors of survival and prognosis of patients, and it is worthy of clinical promotion.
【作者单位】：济南市传染病医院;
【分类号】：R512.62;R575.3

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