摘要
目的分析肝功能衰竭患者主要临床指标与预后的关系。方法选取2008年1月至2014年12月首都医科大学附属北京地坛医院收治的96例肝功能衰竭患者为研究对象,住院期间或出院90 d内病死者为病死组(36例),其余为存活组(60例),分析两组患者肝功能、肾功能、电解质、血糖(blood glucose,Glu)、甘油三酯(triglyceride,TG)、胆固醇(total cholesterol,TC)、甲胎蛋白(alpha feto protein,AFP)、凝血酶原活动度(prothrombin activity,PTA)等指标的差异,采用多因素Logistic回归模型分析肝功能衰竭预后的独立危险因素。结果病死组与存活组患者总胆红素(total bilirubin,TBil)、白蛋白(albumin,ALB)、AFP、PTA、血钠(serum sodium,Na)、白细胞(leukocyte,WBC)、血肌酐(serumcreatinine,SCr)及Glu水平差异有统计学意义(P均<0.05)。多因素Logistic回归分析表明PTA和SCr是肝衰竭预后的独立影响因素(OR=0.919,P=0.006;OR=5.594,P<0.001)。ROC曲线分析表明PTA和SCr的曲线下面积(areaundercurve,AUC)分别为0.732、0.828,相应Cut-off值分别为21%(敏感度64%,特异性72%)和128μmol/L(敏感度69%,特异性88%)。结论 PTA和SCr为肝功能衰竭患者预后的独立影响因素,PTA为保护因素,SCr为危险因素。
Objective To analyze the relationship between main clinical indexes and prognosis of patients with liver failure.Methods Total of 96 cases with liver failure in Beijing Ditan Hospital,Capital Medical University from January 2008 to December 2014 were selected,patients died in the hospital or discharged from hospital within 90 days were in death group(36 cases),and the rest were in surviving group(60 cases).The differences of liver function,renal function,electrolyte,blood glucose(Glu),triglyceride(TG),total cholesterol(TC),alpha feto protein(AFP)and prothrombin activity(PTA)of patients in two groups were compared.The independent risk factors for prognosis of liver failure were analyzed by multivariate Logistic regression analysis.There were significant differences in total bilirubin(TBil),albumin(ALB),AFP,PTA,serum sodium(Na),leukocyte(WBC),serum creatinine(SCr)and Glu levels between the two groups(P<0.05).Results Logistic regression analysis showed that PTA(OR = 0.919,P = 0.006)and SCr(OR = 5.594,P<0.001)were independent risk factors for the prognosis of liver failure.ROC curve showed that the area under curve(AUC)of PTA and SCr were 0.732 and 0.828,respectively.The corresponding Cut-off values were 21%(sensitivity 64%,specificity 72%)and 128 μmol/L(sensitivity 69%,specificity 88%),respectively.Conclusions PTA and SCr were independent prognostic factors that affect the prognosis of patients with liver failure.PTA was the protective factor and SCr was the risk factor.
作者
赵俊梅
张璐
赵培利
李艳静
刘坤
赵志军
王建英
陈璀
刁青
段银环
李明慧
谢尧
ZHAO Jun-mei;ZHANG Lu;ZHAO Pei-li;LI Yan-jing;LIU Kun;ZHAO Zhi-jun;WANG Jian-ying;CHEN Cui;DIAO Qing;DUAN Yin-huan;LI Ming-hui;XIE Yao(Department of Liver Diseases,the Third Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei Province,China;Liver Diseases Center,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)
出处
《中国肝脏病杂志（电子版）》
CAS
2019年第1期68-71,共4页
Chinese Journal of Liver Diseases：Electronic Version
基金
秦皇岛市科学技术局项目(201401A226)
北京市科技计划子课题(D161100002716002)
首都临床特色应用研究(Z151100004015122)
北京市医院管理局临床医学发展专项(XMLX201706)
北京市医院管理局消化内科学科协同发展中心(XXZ0302
XXT28)
国家科技重大专项(2017ZX10201201-001-006)
