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目的对影响重型肝炎患者预后的因素进行分析和评估,对重型肝炎患者预后进行科学的预测。方法将2001-10~2004-06中国医科大学第二临床学院感染科收治的重型肝炎住院患者126例,分为死亡组(82例)与生存组(44例),比较两组在年龄、性别、亚型、生化指标、合并症上的差异。结果两组重型肝炎患者在性别、亚型方面比较差异无显著性(均为P>0.05)。≤40岁与>40岁患者的病死率比较差异有非常显著性(P<0.01);在生化指标上两组丙氨酸氨基转移酶与天门冬氨酸氨基转移酶的比值(ALT/AST)、总胆红素、直接胆红素与总胆红素比值、白蛋白、凝血酶原活动度、总胆固醇、胆碱脂酶、甲胎蛋白、钠离子比较差异具有显著性;死亡组合并症的发生率明显高于生存组(P<0.01)。结论年龄、ALT/AST、总胆红素、白蛋白、凝血酶原活动度、总胆固醇、胆碱脂酶、甲胎蛋白、钠离子及合并症是影响重型肝炎预后的重要因素。
Objective To analyze and evaluate the factors affecting the prognosis of patients with severe hepatitis and predict the prognosis of patients with severe hepatitis scientifically. Methods One hundred and sixty-six inpatients with severe hepatitis treated in Department of Infectious Diseases, Second Clinical College, China Medical University from October 2001 to June 2004 were divided into two groups: death group (82 cases) and survival group (44 cases) , Subtype, biochemical indicators, complications on the differences. Results There was no significant difference in gender and subtype between the two groups of patients with severe hepatitis (all P> 0.05). There were significant differences in the mortality of patients aged <40 years and> 40 years (P <0.01). The biochemical indexes of ALT / AST ratio (ALT / AST) , Total bilirubin, ratio of direct bilirubin to total bilirubin, albumin, prothrombin activity, total cholesterol, cholinesterase, alpha-fetoprotein, sodium were significantly different; death group complications The incidence was significantly higher than the survival group (P <0.01). Conclusion Age, ALT / AST, total bilirubin, albumin, prothrombin activity, total cholesterol, cholinesterase, alpha-fetoprotein, sodium and complications are the important factors affecting the prognosis of severe hepatitis.