酒精相关性慢性肝衰竭患者临床特点分析

肝脏 ›› 2022, Vol. 27 ›› Issue (9): 963-965.

酒精相关性慢性肝衰竭患者临床特点分析

张丽丽, 胡建华, 汪九重, 李斐然, 王保华

100069 首都医科大学附属北京佑安医院中西医结合中心(张丽丽、胡建华、李斐然,王保华);中国中医科学院广安门医院感染疾病科(汪九重)

收稿日期:2022-02-18 出版日期:2022-09-30 发布日期:2022-10-27
通讯作者: 胡建华,Email:hjhdoc@ccmu.edu.cn

Clinical characteristics of alcohol-related chronic liver failure

ZHANG Li-li^1,2, HU Jian-hua¹, WANG Jiu-chong², LI Fei-ran¹, WANG Bao-hua¹

1. Center for Integrative Chinese and Western Medicine, Beijing You 'an Hospital, Capital Medical University,Beijing 100069,China;
2. Department of Infectious Diseases, Guang 'anmen Hospital, China Academy of Chinese Medical Sciences,Beijing 100053,China

Received:2022-02-18 Online:2022-09-30 Published:2022-10-27
Contact: HU Jian-hua,Email:hjhdoc@ccmu.edu.cn

摘要/Abstract

摘要： 目的总结酒精相关性慢性肝衰竭患者的临床及实验室检查结果。方法回顾性分析2018年1月至2021年6月首都医科大学附属北京佑安医院住院治疗的酒精相关性慢性肝衰竭患者的实验室检查结果。结果 23例患者均伴有黄疸,伴有脾大17例(73.91%),伴有腹水18例(78.26%),伴有肝性脑病7例(30.43%)。患者Hb(84.52±20.69)g/L,MCV(102.57±10.28)fL,贫血类型为轻中度的巨幼红细胞性贫血;ALP升高者11例(47.83%),GGT升高者4例(17.39%);患者PT(26.01±6.83)s,PTA(35.22±11.48)%,INR(2.29±0.60),FIB(1.24±0.56)g/L,PLT (57.35±31.15)×10⁹/L,TBil(165.18±115.12) μmol/L,ALT(23.70±11.09)U/L,有酶胆分离的趋势。结论酒精相关性慢性肝衰竭患者部分实验室检查指标与代偿期及失代偿期的指标有所不同,病情更为严重,预后更差。

关键词: 慢性肝衰竭, 酒精性肝硬化失代偿期, 临床分析

Abstract: Objective To investigate the clinical characteristics and laboratory indexes of patients with alcohol-related chronic liver failure. Methods Laboratory examination results of patients with alcohol-related chronic liver failure admitted to our hospital from January 2018 to June 2021 were retrospectively analyzed. Results A total of 23 cases were enrolled. The incidence rates of jaundice, splenomegaly, ascites, hepatic encephalopathy were 100%, (73.91%), 18 cases (78.26%), and 7 cases (30.43%), respectively. The anemia type of patients in the study was mild to moderate megaloblastic anemia, with Hgb 84.52 ± 20.69 g/L and MCV102.57 ± 10.28f. Eleven cases (47.83%) with elevated alkaline phosphatase (ALP) and 4 (17.39%) with elevated gamma-glutamyl transpeptidase (GGT). The coagulation function of the patients was that prothrombin time (PT) 26.01 ± 6.83s, prothrombin activity (PTA) 35.22 ± 11.48%, international normalized ratio (INR) 2.29 ± 0.60, fibrinogen (FIB) 1.24 ± 0.56 g/L, and platelet (PLT) (57.35 ± 31.15)×10⁹/L. The increase of bilirubin was more obvious and alanine aminotransferase (ALT) were all within the normal reference value range, [total bilirubin (TBil) 165.18 ± 115.12 μmol/L, ALT 23.70 ± 11.09 U/L], and there was a trend of enzyme bile separation. Conclusion Some laboratory indexes of patients with decompensated alcohol-related chronic liver failure or compensated alcohol-related chronic liver failure are different. In patients with compensated alcohol-related chronic liver failure, the disease is more serious and the prognosis is worse.

Key words: Chronic liver failure, Alcoholic cirrhosis decompensated stage, Clinical analysis

张丽丽, 胡建华, 汪九重, 李斐然, 王保华. 酒精相关性慢性肝衰竭患者临床特点分析[J]. 肝脏, 2022, 27(9): 963-965.

ZHANG Li-li, HU Jian-hua, WANG Jiu-chong, LI Fei-ran, WANG Bao-hua. Clinical characteristics of alcohol-related chronic liver failure[J]. Chinese Hepatolgy, 2022, 27(9): 963-965.

参考文献

[1] 肝衰竭诊治指南(2018年版). 中华肝脏病杂志,2019(01):18-26.
[2] 李华,温江华,吴英春,等. 酒精性肝硬化患者临床特征分析. 实用肝脏病杂志,2021,24(03):411-414.
[3] 陈晓黄康龄任晓光. 酒精性肝硬化33例临床分析. 中华内科杂志,1997(06):57-58.
[4] 赵晓芳,林兆霞,文静,等. 酒精性肝硬化患者营养风险及影响因素分析. 重庆医学,2021,50(04):639-643.
[5] 董晓玉. 联合检测凝血四项、D二聚体、纤维蛋白/纤维蛋白原降解产物对肝病患者的临床价值. 血栓与止血学,2016,22(03):283-285.
[6] 王熙瑶,刘宁,文凤,等. 乙型肝炎肝硬化、酒精性肝硬化和自身免疫性肝硬化凝血相关参数比较. 标记免疫分析与临床,2021,28(10):1721-1726.
[7] Zhang Y, Zhao H, Wang X, et al. Effects of Cremophor EL/ethanol/oleinic acid/water microemulsion on human blood components and coagulation function. Colloids Surf B Biointerfaces,2019,180:254-262.
[8] 王圣博. 酒精性肝硬化的临床分析. 中南大学,2009.
[9] 冯雪. 酒精性肝硬化的临床分析. 中国医药指南,2014,12(17):279-280.
[10] Wang W, Pan Y, Tang X, et al. Serum prealbumin and its changes over time are associated with mortality in acute kidney injury. Sci Rep,2017,7:41493.
[11] 孟祥洁. 血清视黄醇结合蛋白、前白蛋白、胆碱脂酶水平联合检测对慢性肝炎患者的诊断价值. 河南医学研究,2020,29(15):2843-2845.
[12] 张淑平,金玉,曹波,等. 前清蛋白和视黄醇结合蛋白对儿童肝损害的评估价值. 中华实用儿科临床杂志,2020,35(12):929-931.
[13] 慕永平,张笑,范魏巍,等. 黄芪总皂苷抑制Notch信号通路抗胆汁性肝纤维化的作用机制. 中华肝脏病杂志,2017,25(08):575-582.
[14] Trieb M, Rainer F, Stadlbauer V, et al. HDL-related biomarkers are robust predictors of survival in patients with chronic liver failure. J Hepatol,2020,73(1):113-120.