198例肝硬化失代偿期患者预后多因素分析
摘要
目的:探讨影响肝硬化失代偿期患者生存时间的主要因素。方法:对具有完整临床资料和随访结局的198例肝硬化失代偿期患者进行回顾性分析。分别记录性别、肝硬化病因、年龄、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、白蛋白、球蛋白、凝血酶原时间、部分凝血活酶时间、纤维蛋白原、腹水程度、血钠浓度、自发性腹膜炎、肝性脑病、食管胃底静脉曲张破裂出血等23项指标,采用Kaplain- Meier及Log- rank检验进行单因素分析。再将单因素分析有统计学意义的指标引入Cox模型进行多因素分析。结果:单因素分析显示年龄、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、白蛋白、球蛋白、凝血酶原时间、纤维蛋白原、腹水程度、血钠、总胆固醇、高密度脂蛋白、HBV-DNA、自发性腹膜炎、肝性脑病、食管胃底静脉曲张破裂出血等15项指标与肝硬化失代偿期患者生存时间相关( P < 0. 05)。多因素分析显示天门冬氨酸氨基转移酶、球蛋白、HBV-DNA、自发性腹膜炎、肝性脑病、食道胃底静脉曲张破裂出血等6项指标与肝硬化失代偿期患者生存时间有显著相关性( P < 0. 05)。结论:天门冬氨酸氨基转移酶、球蛋白、HBV-DNA、自发性腹膜炎、肝性脑病、食管胃底静脉曲张破裂出血是影响肝硬化失代偿期患者预后的重要因素。
Objective:To study the factors influencing the prognosis of the patients with decompensate hepatic cirrhosis. Methods:198 cases diagnosed as decompensate cirrhosis were retrospectively recorded and followed up. 23 clinical and laboratory parameters were investigated as predictive risk factors for patients. 23 clinical and laboratory parameters contained gender,cause of the decompensate cirrhosis,age, aspartate amino transferase,alanine amino transferase, albumin, globulin , prothrombin time,partial thromboplastin time,fibrinogen, ascites, serum sodium, spontaneous peritonitis,hepatic encephalopathy, esophageal-gastric variceal bleeding and so on.Using Kaplan-Meier method and Log- rank test for univariate analysis and using Cox proportional hazard regression for multivariate analysis. Results: According to the univariate analysis ,15 indexes such as age , aspartate amino transferase, alanine aminotransferase, serum albumn, globulin,, prothrombin time,fibrin,ascites , sodium concentration, total cholesterol, high density lipoprotein,hepatitis b virus copy, spontaneous peritonitis, hepatic encephalopathy and esophageal-gastric variceal bleeding were related to the prognosis of the patients with decompensate hepatic cirrhosis (P<0.05). Cox proportional hazard regression indicated that aspartate amino transferase, globulin, HBV-DNA, spontaneous peritonitis,hepatic encephalopathy and esophageal-gastric variceal bleeding had had significant influence on the prognosis of hepatic cirrhosis patients(P<0.05). Conclusion:The factors which were related to the prognosis of the patients with decompensate hepatic cirrhosis were aspartate amino transferase, globulin, HBV-DNA, spontaneous peritonitis,hepatic encephalopathy and gastroesophageal variceal bleeding.
Objective:To study the factors influencing the prognosis of the patients with decompensate hepatic cirrhosis. Methods:198 cases diagnosed as decompensate cirrhosis were retrospectively recorded and followed up. 23 clinical and laboratory parameters were investigated as predictive risk factors for patients. 23 clinical and laboratory parameters contained gender,cause of the decompensate cirrhosis,age, aspartate amino transferase,alanine amino transferase, albumin, globulin , prothrombin time,partial thromboplastin time,fibrinogen, ascites, serum sodium, spontaneous peritonitis,hepatic encephalopathy, esophageal-gastric variceal bleeding and so on.Using Kaplan-Meier method and Log- rank test for univariate analysis and using Cox proportional hazard regression for multivariate analysis. Results: According to the univariate analysis ,15 indexes such as age , aspartate amino transferase, alanine aminotransferase, serum albumn, globulin,, prothrombin time,fibrin,ascites , sodium concentration, total cholesterol, high density lipoprotein,hepatitis b virus copy, spontaneous peritonitis, hepatic encephalopathy and esophageal-gastric variceal bleeding were related to the prognosis of the patients with decompensate hepatic cirrhosis (P<0.05). Cox proportional hazard regression indicated that aspartate amino transferase, globulin, HBV-DNA, spontaneous peritonitis,hepatic encephalopathy and esophageal-gastric variceal bleeding had had significant influence on the prognosis of hepatic cirrhosis patients(P<0.05). Conclusion:The factors which were related to the prognosis of the patients with decompensate hepatic cirrhosis were aspartate amino transferase, globulin, HBV-DNA, spontaneous peritonitis,hepatic encephalopathy and gastroesophageal variceal bleeding.
引文
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