核苷类似物治疗乙型肝炎患者发生慢加急性肝衰竭短期预后的生存状况研究

发布时间：2018-04-18 05:12

本文选题：肝功能衰竭 + 乙型肝炎　；参考：《重庆医学》2015年07期

【摘要】：目的探讨核苷类似物治疗乙型肝炎患者发生慢加急性肝衰竭(ACLF)短期预后生存情况和预后独立危险因素。方法收集该院于2010年1月1日至2012年12月31日收治的乙型肝炎ACLF患者共120例,分为常规治疗的对照组60例和核苷类似物治疗组60例,比较两组患者生存时间,应用Cox回归模型预测预后因素。结果治疗18周时治疗组累积生存率为66.7%(40/60),明显高于对照组的46.7%(28/60),差异有统计学意义(χ2=4.887,P0.05)。Cox回归模型显示,早、中期核苷类似物治疗、凝血酶原活动度升高是降低患者病死风险的保护因素,相对危险度(OR,95%CI)分别为0.516(0.315~0.845)、0.613(0.452~0.831)、0.764(0.632~0.924),肝性脑病、肝肾综合征[OR,95%CI分别为:1.876(1.245~2.827)、2.131(1.121~4.051)]可以显著增加患者的近期死亡风险。结论核苷类似物治疗可以提高乙型肝炎患者发生ACLF后的生存率,肝性脑病、肝肾综合征、凝血酶原活动度、疾病分期、是否核苷类似物治疗是影响患者生存时间的独立危险因素。
[Abstract]:Objective to investigate the survival and independent prognostic factors of nucleoside analogues in patients with chronic and acute hepatic failure (ACLF).Methods from January 1, 2010 to December 31, 2012, 120 patients with ACLF were divided into two groups: control group (n = 60) and nucleoside analogue group (n = 60).Cox regression model was used to predict prognostic factors.Results at 18 weeks after treatment, the cumulative survival rate in the treatment group was 66.7 / 60%, which was significantly higher than that in the control group (46.710 / 28 / 60). The difference was statistically significant (蠂 ~ 2 / 4.887 / P 0.05N 路Cox regression model).Increased prothrombin activity was the protective factor to reduce the risk of disease and death. The relative risk of prothrombin activity was 0. 516 ~ 0. 315P ~ (0.845) ~ 0. 613 ~ 0. 452 ~ 0. 6320. 924, liver encephalopathy, liver and kidney syndrome [OR9595 CI = 1. 876 1. 245t = 2. 8275U 2.131n 1.1214.051respectively] could significantly increase the risk of death in the near future in patients with acute hepatic encephalopathy (OR 95 CI = 1. 8761.245t = 2. 8275C = 2. 8271.131a 1.1214.051).Conclusion Nucleoside analogue therapy can improve the survival rate, hepatic encephalopathy, hepatorenal syndrome, prothrombin activity and stage of hepatitis B patients with ACLF.Nucleoside analogue therapy is an independent risk factor for survival time.
【作者单位】：重庆市万州区人民医院消化肝病科;
【分类号】：R512.62;R575.3

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