论文部分内容阅读
目的进一步了解急性重型和亚急性重型肝炎(简称急重和亚急重)患者的临床特征,以及它们之间的异同。方法收集和整理215例急重和亚急重住院患者的临床资料,使用χ2检验、t检验、回归分析等方法进行相关的统计学分析。结果①乙型肝炎病毒感染仍是急重和亚急重型肝炎的主要病因,均占30%以上。抗结核药物是药物性急重和亚急重肝炎的首要原因;②急重和亚急重患者肝性脑病发生率分别为78.13%和43.05%,差异有统计学意义(P<0.001);③急重患者的平均凝血酶原活动度低于20%,而亚急重患者平均凝血酶原活动度低于30%;④急重患者发生率前三位的并发症分别为肝性脑病、电解质紊乱及脑水肿;而亚急重则分别为腹水、电解质紊乱及肝性脑病;⑤急重和亚急重患者的病死率与病情最重时PT、WBC及中性粒细胞比例均呈正相关,而与PTA、TC均呈负相关;亚急重还与病情最重时TB、BLA及CRE呈正相关,与CHE、TG、PLT、ALB呈负相关。结论①急重和亚急重患者无论在好发年龄、肝性脑病发生率、肝性脑病出现时间,还是在凝血功能异常、预后与实验室指标等方面差异较大,属两个独立的疾病;②对于无肝性脑病的急重和亚急重患者,严重的凝血功能异常是一个重要的灵敏和特异性指标。
Objectives To further understand the clinical features of patients with acute and subacute severe hepatitis (referred to as acute and subacute severe), and their similarities and differences. Methods The clinical data of 215 patients with acute and subacute severe inpatients were collected and collated, and the related statistical analysis was carried out by χ2 test, t test and regression analysis. Results ① Hepatitis B virus infection was still the main cause of severe and subacute severe hepatitis, accounting for more than 30%. Antituberculosis drugs were the leading cause of drug-induced acute and severe acute hepatitis; ② The incidence of hepatic encephalopathy in severe and subacute severe patients were 78.13% and 43.05%, respectively, with significant difference (P <0.001); ③ acute The average prothrombin activity of severe patients was less than 20%, while the average prothrombin activity of sub-acute heavy patients was less than 30%. ④ The top three complications of severe patients were hepatic encephalopathy, electrolyte imbalance And cerebral edema; while subacute was respectively ascites, electrolyte imbalance and hepatic encephalopathy; â’¤ dead and severe acute subacute severe case of patients with the most severe cases when the ratio of PT, WBC and neutrophil were positively correlated, and Negatively correlated with PTA and TC. Subacute weight was also positively correlated with TB, BLA and CRE, and negatively correlated with CHE, TG, PLT and ALB. Conclusions ① In severe and subacute severe patients, there are two independent diseases in terms of their age of onset, the incidence of hepatic encephalopathy, the appearance time of hepatic encephalopathy, coagulation dysfunction, prognosis and laboratory indexes ; ② For patients with no severe acute and subacute severe hepatic encephalopathy, severe coagulation dysfunction is an important sensitive and specific indicators.