急性乙型肝炎相关肝衰竭的临床特征及预后分析

肝脏 ›› 2021, Vol. 26 ›› Issue (2): 118-120.

急性乙型肝炎相关肝衰竭的临床特征及预后分析

赖曼, 刘海霞

100069 首都医科大学附属北京佑安医院重症监护室

收稿日期:2020-07-02 出版日期:2021-02-28 发布日期:2021-03-28
通讯作者: 刘海霞,Email:lhx52@126.com

Clinical characteristics and prognosis of hepatitis B-related acute liver failure

LAI Man, LIU Hai-xia

Intensive Care Unit, Beijing Youan Hospital, Capital Medical University, Beijing 100069,China

Received:2020-07-02 Online:2021-02-28 Published:2021-03-28
Contact: LIU Hai-xia, Email: lhx52@126.com

摘要/Abstract

摘要： 目的探讨急性乙型肝炎(acute hepatitis B,AHB)相关肝衰竭(acute liver failure,ALF)患者不良预后的临床特征。方法回顾性分析北京佑安医院2010年1月至2020年1月收治的14例急性乙型肝炎肝衰竭的患者的临床资料,进行统计学分析。结果 14例急性乙型肝炎相关的肝衰竭患者中7例治愈,7例死亡。入院时治愈和死亡患者的ALT分别为(5476.42±2072.84)和(5081.68±3244.44)U/L,TBil分别为(241.26±82.76)和(220.37±107.99)μmol/L,HBV DNA分别为(3.04±7.05)和(2.59±6.05)×10⁵ IU/mL,差异均无统计学意义(均P<0.05)。但入院时肝性脑病分期存活组5例为2期,2例为4期,而死亡组6例为4期,1例为3期,差异有统计学意义(P<0.05),存活组和死亡组的血氨水平分别为(141.71±66.68)和(248.50±100.61)μg/mL,PTA分别为(14.86±5.21)%和(3.01±2.48)%,差异有统计学意义(P<0.05)。结论急性乙型肝炎相关肝衰竭患者发病率低,病死率高,入院时肝性脑病程度、血氨升高的水平以及PTA下降的程度可能与预后不良有关。

关键词: 急性乙型肝炎, 急性肝衰竭, 预后

Abstract: Objective To study on the clinical characteristics and prognosis factors of hepatitis B-related acute liver failure.Methods A total of 14 cases with hepatitis B-related Acute Liver Failure (ALF) were collected from January 2010 to January 2020. They were divided into the survival group and the dead group based on their outcomes. Their clinical features and laboratory examinations were collected and analyzed by SPSS statistic software. Results Within the 14 cases of Hepatitis B-related ALF, 7 (50%) patients were cure and 7 (50%) patients died. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total Bilirubin (TBIL) and HBV DNA did not differ obviously between these two groups at admission. However, there were significant difference in blood ammonia (NH3) level, grades of hepatic encephalopathy, and prothrombin time activity (PTA) (P<0.05).Conclusion Acute hepatitis B-related acute liver failure is one of the rare critical clinical conditions, which have the features of acute onset, quick progression and high mortality. The degree of hepatic encephalopathy, high serum ammonia level and decreased PTA at admission may indicate a poor prognosis.

Key words: Acute hepatitis B, Acute liver failure, Prognosis

赖曼, 刘海霞. 急性乙型肝炎相关肝衰竭的临床特征及预后分析[J]. 肝脏, 2021, 26(2): 118-120.

LAI Man, LIU Hai-xia. Clinical characteristics and prognosis of hepatitis B-related acute liver failure[J]. Chinese Hepatolgy, 2021, 26(2): 118-120.

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