【摘要】 目的探讨影响肝硬化患者预后的危险因素,为临床治疗决策提供指导。方法对资料完整的肝炎肝硬化患者112例(存活组65例,死亡组47例),统计年龄、肝硬化并发症、肝脏生化、腹水检查结果21项指标,进行单因素分析。结果分析发现年龄、消化道出血、原发性肝癌、肝性脑病、感染、肝肾综合征、腹水、脾功能亢进、自发性腹膜炎、腹水白细胞、外周白细胞、凝血酶原活动度、白蛋白、血清胆红素、血尿素氮、低钠血症、肝炎病毒复制与肝炎肝硬化预后显著相关(P<0.05～0.001)。预后相关强度分析(0R值)发现肝性脑病、肝肾综合征、凝血酶原活动度、胆红素、低钠血症是影响肝炎肝硬化患者预后的独立危险因素。结论肝硬化患者的病情严重程度和预后受到多种因素影响,死亡主要原因为肝功能衰竭、肝细胞癌、消化道出血。更多还原

【Abstract】 Objective To study the risk factors of predictive survival of the patients with decompensated hepatic cirrhosis, and direct the manegement of clinical decision. Methods 112 cases diagnosed as decompensated hepatic cirrhosis at the end of hospitalization were divided into survival group (n=65) and death group (n=47). 21 clinical and laboratory parameters were investigated as predictive risk factors for patients survival. Univariate analysis was made with the Chi-Square test for qualitative variable and independent sample t-test for quantitative variable. Results 17 clinical and laboratory parameters, age, GI bleeding, hepatic cell carcinoma, hepatic encephalopathy, infection, syndrome of hepatic-kinedy, ascites, hypersplenism, spontaneous bacterial peritonitis, count of ascites WBC and blood WBC, PTA, total brilirubin, serum ALB, sodium concentration, hepatitis virus copy and BUN ,were closely related to survival of the patients with decompensated hepatic cirrhosis by univariate analysis (P<0.05～0.001). The prognosis of the patients was influenced by 5 independent factors, that is hepatic cell carcino ma, hepatic encephalopathy (HE), PTA, serum sodium concentration (Na) and BUN by Odds ratios analysis. Conclusion Multiple risk factors affect cirrhotic patients. The main death causes are liver function failure, hepatic cell carcinoma and GI bleeding.更多还原