Olevskaya E R, Dolgushina A I, Tarasov A N, Hihlova A O
South Ural State Medical University of the Ministry of Health of the Russian Federation, Chelyabinsk, Russia.
Ter Arkh. 2019 Mar 18;91(2):67-72. doi: 10.26442/00403660.2019.02.000089.
To study prognostic factors for survival in patients of liver cirrhosis (LC) with portal hypertension (PG).
155 patients (women - 49.4%, men - 50.6%, median age 56.4 years [51.3; 61.6]) were follow up for 36 months. Viral LC was diagnosed in 33.8%, alcohol LC - 22.1%, autoimmune LC - 15.6%, other causes and cryptogenic causes noted in - 28.5%. More than half of the patients had a class В of Child-Pugh (51.9%).
During the study period 42 patients (28.3%) died. The analysis of survival by various factors for Kaplan-Mayer was carried out. Significant predictors: Child-Pugh class, LC etiology, comorbidity in Charlson scores, adherence to endoscopic treatment of esophageal varices were included in the model of proportional Cox risks. In a single-factor analysis, the risk of death is higher in patients who violate the timing of endoscopic treatment, but this factor has lost significance in the multifactor model. Patient with Child-Pugh C, alcoholic LC, comorbidity more 5 points by Charlson score have a higher mortality risk.
Identification of risk factors that affect the survival of LC patients will allow to use of an individual plan for the LC treatment and prevention of PG complications.
研究肝硬化（LC）合并门静脉高压（PG）患者的生存预后因素。
对155例患者（女性占49.4%，男性占50.6%，中位年龄56.4岁[51.3；61.6]）进行了36个月的随访。病毒性LC诊断率为33.8%，酒精性LC为22.1%，自身免疫性LC为15.6%，其他原因及隐源性原因占28.5%。超过半数患者为Child-Pugh B级（51.9%）。
研究期间42例患者（28.3%）死亡。采用Kaplan-Mayer法对各因素的生存情况进行分析。显著预测因素：Child-Pugh分级、LC病因、Charlson评分中的合并症、食管静脉曲张内镜治疗的依从性被纳入比例Cox风险模型。单因素分析中，内镜治疗时机延误的患者死亡风险较高，但该因素在多因素模型中失去意义。Child-Pugh C级、酒精性LC、Charlson评分合并症超过5分的患者死亡风险较高。
识别影响LC患者生存的危险因素将有助于制定个体化的LC治疗方案及预防PG并发症。
