摘要
目的探讨乙肝肝硬化并发肝肾综合征(HRS)的危险因素。方法 2004年1月～2011年1月本院收治的乙肝肝硬化患者642例(其中发生肝肾综合征46例),收集患者的性别、年龄,发现乙肝病史时程,Child-Pugh评分,丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、碱性磷酸酶、γ-谷氨酰转移酶、胆碱酯酶、血钠、白蛋白、前白蛋白、总胆红素、凝血酶原时间和活化部分凝血活酶时间、腹水程度,是否存在感染、消化道出血、强烈利尿、大量放腹水及应用氨基糖苷类药物等相关资料,进行单因素和多因素非条件Logistic回归模型分析。结果单因素和多因素非条件Logistic回归分析显示,Child-Pugh评分、腹水程度、感染是并发HRS的危险因素(P<0.05),OR值分别为6.21、3.57和4.56。结论Child-Pugh评分C级、大量腹水、伴发感染为乙肝肝硬化并发HRS的独立危险因素,对于该类患者应采取适当的干预措施。
Objective To explore the risk factors for hepatitis B-related liver cirrhosis and hepatorenal syndrome（HRS）.Methods There were 642 patients with hepatitis B-related liver cirrhosis treated at this hospital from January 2004 to January 2011.Of these patients,46 developed HRS.These patients were analyzed retrospectively.The patients＇ clinical data were collected,including sex,age,history of hepatitis B,Child-Pugh score,levels of alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,γ-glutamyl transferase,cholinesterase,serum sodium,albumin,prealbumin,and total bilirubin,prothrombin time,activated partial thromboplastin time,degree of ascites,infection,gastrointestinal bleeding,strong diuresis,a large volume of drained ascites,and use of an aminoglycoside.The data were statistically analyzed by univariate and multivariate unconditional logistic regression.Results Univariate and multivariate unconditional logistic regression analysis revealed that the Child-Pugh score,degree of ascites,and infection were risk factors for development of HRS（P〈0.05）,with OR of 6.21,3.57,and 4.56,respectively.Conclusion A class C Child-Pugh score,a large volume of ascites,and infection are unique risk factors for the presence of HRS in patients with hepatitis B-related liver cirrhosis.Appropriate preventive measures need to be taken for patients with these risk factors.
出处
《中国病原生物学杂志》
CSCD
北大核心
2012年第2期115-117,共3页
Journal of Pathogen Biology
