Ennaifer Rym, Ouakaa-Kchaou Asma, BelHadj Najet, Elloumi Héla, Gargouri Dalila, Kochlef Asma, Kilani Afef, Romani Malika, Kharrat Jamel, Ghorbel Abdeljabbar
Service de Gastroentérologie, Centre Hospitalo-Universitaire Habib Thameur.
Tunis Med. 2007 Dec;85(12):1039-43.
Assessment of prognosis in patients with cirrhosis is important so as to plan their management as well as the choice of major procedures. The aim of the present study was to determine the survival rates and to identify indicators associated with shorter life expectancy in Tunisians patients with cirrhosis.
This is a retrospective study of patients with cirrhosis admitted during 14-years period. We studied clinical and biochemical characteristics of all patients and the occurrence of decompensation or complication (gastro-intestinal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, hepato-renal syndrome, hepatocellular carcinoma). The overall survival, mortality rate and causes of death were reviewed. Univariate and multivariate analysis was performed on all variables to identify parameters associated with a lower life expectancy.
We studied 85 patients (50 females/35 males) with a mean age of 57 years. Mean follow up was 31 months. The overall survival was 47% at 5 years. With univariate analysis, 13 variables were associated with a poor prognosis: male sex, jaundice, ascites, and decompensation at admission, increased serum gammaglobulin, gammaGT, bilirubine and ASAT levels, Child-Pugh C, occurrence of spontaneous bacterial peritonitis, hepatic encephalopathy, hepato-renal syndrome and hepatocellular carcinoma. With multivariate analysis, 2 variables were independently correlated with survival:male sex and elevated gammaGT.
In our study, male sex, increased serum gammaGT and gammaglobulin are uncommon parameters that may predict survival in cirrhotic patient. The Child-Pugh score was a good index for assessing the prognosis.
评估肝硬化患者的预后对于规划其治疗方案以及重大手术的选择非常重要。本研究的目的是确定突尼斯肝硬化患者的生存率，并识别与预期寿命缩短相关的指标。
这是一项对14年间收治的肝硬化患者进行的回顾性研究。我们研究了所有患者的临床和生化特征以及失代偿或并发症（胃肠道出血、肝性脑病、自发性细菌性腹膜炎、肝肾综合征、肝细胞癌）的发生情况。回顾了总生存率、死亡率和死亡原因。对所有变量进行单因素和多因素分析，以识别与较低预期寿命相关的参数。
我们研究了85例患者（50名女性/35名男性），平均年龄57岁。平均随访时间为31个月。5年总生存率为47%。单因素分析显示，13个变量与预后不良相关：男性、黄疸、腹水、入院时失代偿、血清γ球蛋白、γ谷氨酰转移酶、胆红素和谷草转氨酶水平升高、Child-Pugh C级、自发性细菌性腹膜炎、肝性脑病、肝肾综合征和肝细胞癌的发生。多因素分析显示，2个变量与生存独立相关：男性和γ谷氨酰转移酶升高。
在我们的研究中，男性、血清γ谷氨酰转移酶和γ球蛋白升高是可能预测肝硬化患者生存的不常见参数。Child-Pugh评分是评估预后的良好指标。
