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中国乙型肝炎病毒相关性肝衰竭的流行病学和临床特征。

Epidemiological and clinical features of hepatitis B virus related liver failure in China.

机构信息

Department of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.

出版信息

World J Gastroenterol. 2011 Jul 7;17(25):3054-9. doi: 10.3748/wjg.v17.i25.3054.

Abstract

AIM

To examine the epidemiologic and clinical characteristics of hepatitis B virus (HBV) related liver failure in patients in China.

METHODS

This study was conducted with a retrospective design to examine 1066 patients with HBV-related liver failure in the southwest of China.

RESULTS

There were more male than female patients. Young and middle-aged people comprised most of the patients. Farmers and laborers comprised the largest proportion (63.09%). Han Chinese accounted for 98.12%, while minority ethnic groups only accounted for 0.88% of patients. A total of 43.47% patients had a family history of HBV-related liver failure and 56.66% patients had a history of drinking alcohol. A total of 42.59% patients with HBV-related liver failure had definite causes. With regard to the clinical manifestation of HBV-related liver failure, the symptoms were: hypodynamia, anorexia and abdominal distension. Total bilirubin (TBIL) and alanine aminotransferase (ALT) levels were altered in 46.23% of patients with evident damage of the liver. Univariate logistic regression analysis showed that the patients' prognoses were correlated with ALT, aspartate aminotransferase, albumin, TBIL, prothrombin activity (PTA), and alpha-fetoprotein levels, and drinking alcohol, ascites, hepatorenal syndrome, infection and ≥ 2 complications. Multifactor logistic regression analysis showed that the activity of thrombinogen and the number of complications were related to the prognosis.

CONCLUSION

Alcohol influences the patients' prognosis and condition. PTA and complications are independent factors that can be used for estimating the prognosis of HBV-related liver failure.

摘要

目的

研究中国乙型肝炎病毒(HBV)相关肝衰竭患者的流行病学和临床特征。

方法

本研究采用回顾性设计,对中国西南地区 1066 例 HBV 相关肝衰竭患者进行了研究。

结果

患者中男性多于女性。中青年患者居多。农民和劳动者占最大比例(63.09%)。汉族占 98.12%,少数民族仅占 0.88%。共有 43.47%的患者有 HBV 相关肝衰竭家族史,56.66%的患者有饮酒史。共有 42.59%的 HBV 相关肝衰竭患者有明确病因。HBV 相关肝衰竭的临床表现为乏力、食欲不振和腹胀。46.23%的患者出现肝功能明显损害,总胆红素(TBIL)和丙氨酸氨基转移酶(ALT)水平改变。单因素 logistic 回归分析显示,患者的预后与 ALT、天冬氨酸氨基转移酶、白蛋白、TBIL、凝血酶原活动度(PTA)和甲胎蛋白水平以及饮酒、腹水、肝肾综合征、感染和≥2 种并发症有关。多因素 logistic 回归分析显示,凝血酶原活度和并发症的数量与预后有关。

结论

饮酒影响患者的预后和病情。PTA 和并发症是可以用来评估 HBV 相关肝衰竭预后的独立因素。

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[New concept in nomenclature, classification and diagnosis of liver failure].
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