临床肝胆病杂志2018，Vol.34Issue(3)：548-552,5.DOI:10.3969/j.issn.1001-5256.2018.03.020
基于世界胃肠病学大会提议的HBV相关慢加急性肝衰竭的临床特征及分型探讨
Clinical features and typing of hepatitis B virus-related acute-on-chronic liver failure based on recommendations of the World Congress of Gastroenterology
摘要
Abstract
Objective To investigate the clinical features and prognosis of patients with different types of hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF). Methods A retrospective analysis was performed for the clinical data of 296 patients with HBV-ACLF who were admitted to 302 Hospital of PLA from January to December,2016 and diagnosed based on recommendations of the World Congress of Gastroenterology,and according to the pathogenesis,these patients were divided into chronic hepatitis group(type A group with 53 pa-tients),compensated cirrhosis group(type B group with 151 patients),and decompensated cirrhosis group(type C group with 92 pa-tients). Laboratory markers,incidence of comorbidities,and prognosis were analyzed for all groups. An analysis of variance was used for comparison of normally distributed continuous data with homogeneity of variance between multiple groups,and the least significant difference t-test was used for further comparison between two groups;the Kruskal-Wallis H test was used for comparison of non-normally distribu-ted continuous data or continuous data with heterogeneity of variance between groups. The Pearson′s chi-square test was used for compari-son of categorical data between groups. Results There were significant differences in albumin,alanine aminotransferase,and cholinesterase between the three groups(all P<0.05),and the type A group had the highest levels,followed by the type B group and the type C group. The type A group had significantly higher levels of aspartate aminotransferase and platelet count than the type B group and the type C group (all P<0.05). The type A group and the type B group had a significantly higher level of total cholesterol than the type C group(both P<0.05). Compared with the type A group and the type B group,the type C group had significantly higher incidence rates of ascites/pleural ef-fusion(90.22% vs 69.81%/88.08%,χ2=12.964,P<0.05)and hepatorenal syndrome(43.48% vs 18.87%/28.48%,χ2=10.691, P<0.05). The type B group and type C group had a significantly higher incidence rate of peritonitis than the type A group(40.40%/48.91% vs 22.64%,χ2=9.718,P<0.05). There was a significant difference in improvement rate between the three groups(52.83% vs 45.70% vs 32.61%,χ2=6.593,P<0.05). Conclusion There are significant differences in biochemical parameters,comorbidities, and prognosis between HBV-ACLF patients with HBV-related chronic hepatitis,compensated cirrhosis,and decompensated cirrhosis. Such a typing method helps to explore treatment measures and assess prognosis.关键词
肝功能衰竭/肝炎病毒,乙型/世界胃肠病学大会Key words
liver failure/hepatitis B virus/World Congress of Gastroenterology分类
医药卫生引用本文复制引用
徐天娇,吕飒,游绍莉,田华,王海波,宋芳娇,朱冰..基于世界胃肠病学大会提议的HBV相关慢加急性肝衰竭的临床特征及分型探讨[J].临床肝胆病杂志,2018,34(3):548-552,5.基金项目
军队优秀青年科技人才扶持对象项目 （）
国家"十三五"科技重大专项(2017ZX10203201-004) （2017ZX10203201-004）
