关键词: 肝硬化, 脑出血, 肝衰竭

Abstract: Objective To analyze the clinical characteristics of patients with cirrhosis and cerebral hemorrhage, to study the prognosis and mortality of these patients, and to investigate the risk factors affecting prognosis. Methods Clinical data of 51 patients with cirrhosis and cerebral hemorrhage in our hospital from December 2008 to July 2018 were collected. The patients were divided into the death and the improvement groups according to discharge conditions. The clinical characteristics of the 2 groups and the risk factors for prognosis were analyzed and discussed. Results Thirty-one patients died when they were discharged from hospital, and the case fatality rate was 61%. Univariate analysis showed that the volumes of hematoma in the death and improvement groups were (57±28) ml and (25±11) ml, platelet counts were (31±27)×10⁹/L and (62±21)×10⁹/L. Numbers of cases with severe disturbance of consciousness were 25 and 5, with Child-Pugh C status was 26 and 8, the differences were statistically significant (P<0.05). Multivariate analysis showed that platelet count was an independent risk factor for prognosis of patients with cirrhosis and cerebral hemorrhage (P<0.05). The cut-off value was 30.5×10⁹/L. The area under receiver operator characteristic curve was 0.894 (0.803-0.986), the sensitivity and specificity were 100% and 77.4%, respectively, and the maximum of Youden’s index was 0.774. Conclusion Platelet count is an independent risk factor for prognosis of patients with cirrhosis complicated with cerebral hemorrhage. The etiology of cirrhosis is related to the occurrence of cerebral hemorrhage, but has no relationship with prognosis.

Key words: Liver cirrhosis, Cerebral hemorrhage, Liver failure