关键词: HBV-ACLF, 临床特点, 预后转归

Abstract: Objective To study the clinical characteristics and prognosis of patients with HBV-related acute-on-chronic liver failure (HBV-ACLF) treated by internal medicine.Methods The clinical data of 140 patients with HBV-ACLF who received comprehensive treatment of internal medicine in our hospital were retrospectively analyzed,the patients were divided into effective group and ineffective group,which accorded to the therapeutic effect.The clinical characteristics of the two groups were compared. Results The medical comprehensive treatment was effective in 98 cases,the effective rate was 70.00%, the ineffective was 42 cases and the ineffective rate was 30%. Among them, 23 cases died and the mortality rate was 16.43%.The incidence of cirrhosis, hepatic encephalopathy, gastrointestinal bleeding and hepatorenal syndrome in the effective group were lower than that in the ineffective group (P<0.05).The Logistic multivariate analysis showed that the complications such as hepatic encephalopathy (OR=1.869,95%CI=1.073~3.256), gastrointestinal bleeding (OR=3.478,95%CI=1.621~7.462), hepatorenal syndrome (OR=4.141,95%CI=1.031~5.091) and INR(OR=3.081,95%CI=1.497~6.341), Scr (OR=2.817,95%CI=1.629~4.871) and MELD scores (OR=1.305,95%CI=1.194~1.426) were independent factors which affected the efficacy (P<0.05).Conclusion The comprehensive curative effect of HBV-ACLF is affirmative.The entecavir combined with glucocorticoid is helpful to improve the curative effect.The patients who decreased liver function and elevated MELD score, the therapeutic effect of internal medicine for those with complications is worse.

Key words: HBV-ACLF, Clinical features, Prognosis