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[目的]探讨慢加急性肝衰竭(ACLF)与慢性肝衰竭(CLF)的临床特点和预后差异。[方法]75例慢性重型肝炎患者按肝衰竭诊疗指南分为ACLF组(27例)和CLF组(48例),比较2组一般情况、实验室指标、常见并发症、Child-Pugh评分及预后。[结果]CLF组年龄和病程均明显高于ACLF组(P<0.05或P<0.01),2组性别差异无统计学意义;ACLF组血清ALT、TBil、ALB及Na+水平高于CLF组,GLO、TBA低于CLF组(P<0.05或P<0.01);ACLF组血常规参数WBC、HGB和PLT高于CLF组,凝血指标PT低于CLF组(P<0.05或P<0.01),2组Fib差异无统计学意义;ACLF组腹水和肝性脑病发生率低于CLF组(P<0.05或P<0.01),2组腹腔感染、上消化道出血、肝肾综合征及电解质紊乱差异无显著性;ACLF组Child-Pugh评分(9.2±1.7)低于CLF组(12.0±2.5),其预后优于CLF组(P<0.05或P<0.01),2组住院时间差异无统计学意义。[结论]ACLF和CLF患者在年龄、病程、实验室指标、并发症腹水和肝性脑病发生率、Child-Pugh评分及预后均有差异。
[Objective] To investigate the clinical features and prognosis of patients with acute and chronic liver failure (ACLF) and chronic liver failure (CLF). [Methods] Seventy-five patients with chronic severe hepatitis were divided into ACLF group (n = 27) and CLF group (n = 48) according to the guideline of hepatic failure treatment. The general conditions, laboratory indexes, common complication, Child-Pugh score and prognosis . [Results] The age and duration of CLF group were significantly higher than those of ACLF group (P <0.05 or P <0.01). There was no significant difference in gender between the two groups. The levels of ALT, TBil, ALB and Na + in ACLF group were higher than those in CLF group (P <0.05 or P <0.01). The blood parameters WBC, HGB and PLT in ACLF group were higher than those in CLF group, while the PT of coagulation index was lower than that of CLF group (P <0.05 or P <0.01) Fib had no statistical significance. The incidence of ascites and hepatic encephalopathy in ACLF group was lower than that in CLF group (P <0.05 or P <0.01). There was no significant difference in abdominal infection, upper gastrointestinal bleeding, hepatorenal syndrome and electrolyte imbalance in ACLF group The Child-Pugh score of ACLF group (9.2 ± 1.7) was lower than that of CLF group (12.0 ± 2.5), and the prognosis of ACLF group was better than that of CLF group (P <0.05 or P <0.01). There was no significant difference in hospitalization time between the two groups. [Conclusion] The incidence of ascites and hepatic encephalopathy, Child-Pugh score and prognosis of patients with ACLF and CLF are different in age, duration of disease, laboratory indexes, complications.