摘要
目的探讨乙肝相关性慢加急性肝衰竭（HBV-ACLF）患者TBIL、WBC、HGB、PT、PTA、INR的变化趋势。方法选取2014年3月至2015年4月郑州大学第一附属医院收治的86例HBV-ACLF患者,均给予基础内科治疗,根据4周预后情况分为好转组和恶化组,分析TBIL、WBC、HGB、PT、PTA、INR的动态变化趋势。结果恶化组在入院4周内TBIL逐渐升高,存活组在第1周升高至峰值后逐渐下降,死亡组TBIL水平高于存活组（P〈0.05）。4周内两组WBC均逐渐下降,除第3周外,死亡组WBC水平高于存活组（P〈0.05）。4周内两组HGB均逐渐下降,且两组间HGB水平差异无统计学意义（P〉0.05）。4周内死亡组的PT和INR均逐渐上升,存活组均逐渐下降,第1~4周死亡组PT和INR水平均高于存活组（P〈0.05）。4周内死亡组PTA逐渐下降,存活组逐渐上升,第1~4周死亡组PTA水平低于存活组（P〈0.05）。结论通过观察HBV-ACLF患者TBIL、WBC、PT、PTA、INR早期的动态变化趋势可初步反映其预后情况,为临床评估预后及指导治疗提供参考。
Objective To investigate the dynamic changes of total bilirubin（ TBIL）,white blood cells（ WBC）,hemoglobin（ HGB）,prothrombin time（ PT）,prothrombin time activity（ PTA）,international standard value（ INR） of the HBV- associated acute- on- chronic liver failure（ HBV- ACLF）. Methods 86 patients with HBV- ACLF were enrolled and divided into improvement group and deterioration group according to their prognosis at 4 weeks after admission. All patients were administered with the same regimen. And then the dynamic changes of TBIL、WBC、HGB、PT、PTA、INR and its predictive value on prognosis were analyzed. Results TBIL in improvement group increased to peak at week 1 after admission and then declined gradually through week 4,while TBIL in deterioration group increased consistently. Serum TBIL levels in deterioration group were higher than the improvement group（ P 〈 0. 05）. WBC in both groups declined gradually during the four- weeks observational period after admission. WBC levels in deterioration group was higher than the improvement group（ P 〈 0. 05）. However,the week 3 was excluded. HGB in both groups declined gradually during the four- week observational period after admission. No statistical difference was observed for HGB level in both groups（ P 〉 0. 05）. PT and INR in deterioration group increased gradually while declined in improvement group during the four- week observational period after admission. PT and INR levels in deterioration group was higher than the improvement group during the four- week observational period after admission（ P 〈 0. 05）. PTA in deterioration group declined gradually while elevated in improvement group during the four- week observational period after admission. PTA levels in deterioration group was lower than the improvement group（ P 〈 0. 05）. Conclusion The early dynamic changes of TBIL,WBC,PT,PTA and INR could reflect the prognosis and guide the treatment of the HBV- ACLF.
出处
《河南医学研究》
CAS
2016年第3期403-406,共4页
Henan Medical Research
