江西省南昌地区急性肝衰竭病因及临床特点分析

发布时间：2018-06-24 05:42

  本文选题：南昌地区 + 急性肝衰竭　； 参考：《中国现代医学杂志》2017年01期

【摘要】：目的分析江西省南昌地区急性肝衰竭(ALF)的病因和临床特点,并且探讨终末期肝病模型(MELD)评分在评估ALF预后中的价值。方法选取2006年1月-2014年12月该院收治的南昌地区47例成年ALF患者的临床资料进行回顾性分析,包括病因、临床特征、治疗方法和转归等。结果导致南昌地区ALF的病因以乙型肝炎病毒(HBV)感染最为常见,占本组患者的40.4%(19/47),其次为药物引起10例(21.3%),其中抗结核药引起4例,中草药引起3例,抗肿瘤药引起2例,解热镇痛药引起1例;HBV+戊型肝炎病毒重叠感染3例(6.4%),妊娠急性脂肪肝1例,热射病2例,毒蕈中毒2例,病因不明5例(10.6%)。本组患者死亡34例,病死率为72.3%。ALF存活组与死亡组在血清白蛋白、总胆红素、凝血酶原时间、甲胎蛋白、血氨、MELD等比较,差异有统计学意义(P0.05),MELD评分越高,病死率亦越高,但谷丙转氨酶、谷草转氨酶间比较,差异无统计学意义(P0.05)。入院时MELD评分受试者工作特征曲线下面积为0.881,当取Cut-off值为30.2分时,把47例患者分为MELD评分≤30.2和30.2分两组,两组病死率比较,MELD评分≤30.2分组的病死率较低。结论南昌地区HBV感染是导致ALF的首要原因,MELD评分对评估ALF的预后有一定价值。
[Abstract]:Objective to analyze the etiology and clinical features of acute hepatic failure (ALF) in Nanchang area of Jiangxi province and to evaluate the value of meld score in evaluating the prognosis of ALF. Methods the clinical data of 47 patients with adult ALF in Nanchang from January 2006 to December 2014 were retrospectively analyzed, including etiology, clinical features, treatment methods and outcome. Results Hepatitis B virus (HBV) infection was the most common cause of ALF in Nanchang area, accounting for 40.4% (19 / 47) of the patients, followed by 10 cases (21.3%) caused by drugs, including 4 cases caused by anti-tuberculosis drugs, 3 cases by Chinese herbal medicine and 2 cases by anti-tumor drugs. There were 3 cases (6.4%) of hepatitis E virus superinfection caused by antipyretic analgesics, 1 case of acute fatty liver of pregnancy, 2 cases of heat radiation, 2 cases of fungotoxicity, 5 cases (10.6%) of unknown etiology. 34 patients died, the mortality was 72.3%. The higher the score of meld, the higher the mortality of ALF, the higher the serum albumin, total bilirubin, prothrombin time, alpha-fetoprotein, ammoid meld, etc. But there was no significant difference between alanine aminotransferase and alanine aminotransferase (P0.05). At admission, the area under the operating characteristic curve was 0.881. When Cut-off value was 30.2, 47 patients were divided into two groups: meld 鈮，

本文编号：2060281