南方医科大学学报2020，Vol.40Issue(6)：771-777,7.DOI:10.12122/j.issn.1673-4254.2020.06.01
胆汁淤积和缺氧性肝炎对ICU患者预后的影响:基于重症监护-Ⅲ数据库的回顾性分析
Effects of cholestasis and hypoxic hepatitis on prognosis of ICU patients: a retrospective study based on MIMIC Ⅲ database
摘要
Abstract
Objective Abnormalities of liver-related indices are common in ICU patients,but the effects of cholestasis and hypoxic hepatitis in critically ill patients remains unclarified.The purpose of this study was to investigate the effects of cholestasis and hypoxic liver dysfunction on the prognosis of ICU patients.Methods A retrospective study was conducted based on the data of patients admitted to the ICU for the first time between 2001 and 2011 archived in the MIMIC-Ⅲ database.The patients were divided into cholestasis,hypoxic hepatitis and control groups,and their 28-day case fatality rate as the primary outcome was compared among the groups.Results A total of 5852 ICU patients were included in the analysis.The incidence of cholestasis and hypoxic liver dysfunction was 31.9％ (1869/5852) and 17.9％ (1046/5852),respectively.There was no significant difference in 28-day case fatality rate between cholestasis group and the control group.Compared with the control group,the patients with hypoxic hepatitis had a significantly higher 28-day case fatality rate (46％ vs 35％,P＜0.01),a higher hospital case fatality rate (40％ vs 31％,P＜0.01),and a higher ICU case fatality rate (35.7％ vs 22.2％,P＜0.01).Logistic regression analysis showed that lactic acid (LAC),aspartate transaminase (AST),and international standard ratio (INR) were independent risk factors for 28-day case fatality rate.Conclusion The incidence of cholestatic liver dysfunction is higher than that of hypoxic hepatitis,but it does not increase the 28-day case fatality rate of the ICU patients,suggesting that cholestatic liver dysfunction may be the early adaptation of the liver to critical diseases.关键词
胆汁淤积/肝功能障碍/胆红素/碱性磷酸酶/死亡率/转氨酶Key words
cholestasis/hypoxic hepatitis/bilirubin/alkaline phosphatase/transaminase引用本文复制引用
宋慧敏,王静,胡畅,刘畅,李建国..胆汁淤积和缺氧性肝炎对ICU患者预后的影响:基于重症监护-Ⅲ数据库的回顾性分析[J].南方医科大学学报,2020,40(6):771-777,7.基金项目
国家自然科学基金(8157946)Supported by National Natural Science Foundation of China (8157946). （8157946）
