Predictors of the outcomes of acute-on-chronic hepatitis B liver failure

查看全文 作　　者：Hsiu-Lung [1]Fan;Po-Sheng [2]Yang;Hui-Wei [3]Chen;Teng-Wei [1]Chen;De-Chuan [1]Chan;Chi-Hong [1]Chu;Jyh-Cherng [1]Yu;Shih-Ming [4]Kuo;Chung-Bao [1]Hsieh

机构地区：[1]Division of General Surgery,Department of Surgery,Tri-Service General Hospital,National Defense Medical Center;[2]Division of General Surgery,Department of Surgery,Mackay Memorial Hospital;[3]School of Medicine,University of Pittsburgh,Pittsburgh,PA 15261,United States;[4]Division of Pediatric Surgery,Department of Surgery,Tri-Service General Hospital,National Defense Medical Center

出　　处：《World Journal of Gastroenterology》索引2012年第18卷第36期,共6页

基　　金：Supported by Tri-Service General Hospital,No.TSGH-C101-137 摘　　要：AIM:To identify the risk factors in predicting the outcome of acute-on-chronic hepatitis B liver failure patients.METHODS:We retrospectively divided 113 patients with acute-on-chronic liver failure-hepatitis B virus(ACLF-HBV) and without concurrent hepatitis C or D virus infection and hepatocellular carcinoma into two groups according to their outcomes after anti-HBV therapy.Their demographic,clinical,and biochemical data on the day of diagnosis and after the first week of treatment were analyzed using the Mann-Whitney U test,Fisher's exact test,and a multiple logistic regression analysis.RESULTS:The study included 113 patients(87 men and 26 women) with a mean age of 49.84 years.Fiftytwo patients survived,and 61 patients died.Liver failure(85.2%),sepsis(34.4%),and multiple organ failure(39.3%) were the main causes of death.Multivariate analyses showed that Acute Physiology and Chronic Health Evaluation(APACHE) Ⅱ scores ≥ 12 [odds ratio(OR) = 7.160,95% CI:2.834-18.092,P < 0.001] and positive blood culture(OR = 13.520,95% CI:2.740-66.721,P = 0.001) on the day of diagnosis and model for end-stage liver disease(MELD) scores ≥ 28(OR = 8.182,95% CI:1.884-35.527,P = 0.005) after the first week of treatment were independent predictors of mortality.CONCLUSION:APACHE Ⅱ scores on the day of diagnosis and MELD scores after the first week of anti-HBV therapy are feasible predictors of outcome in ACLFHBV patients. 关键词：慢性乙型肝炎肝功能衰竭预测因子急性 Logistic回归分析 FISHER精确检验 APACHE 乙肝病毒

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Predictors of the outcomes of acute-on-chronic hepatitis B liver failure

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