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目的 探讨177例乙肝相关慢加急性肝衰竭(HBV-related acute-on-chronic liver failure, HBV-ACLF)不同亚型的临床特征。方法 回顾性分析2018年1月至2021年12月新疆医科大学第一附属医院感染科收治的177例HBV-ACLF患者的病历资料，分析其临床特征以及与预后相关的检验指标。结果 177例患者中，A型64例(36.1%)、B型7例(4.0%)、C型106例(59.9%),男女比例4.71∶1,平均年龄(42±11)岁，患者发病年龄集中在36～55岁。A、B型患者常以黄疸、乏力、恶心、腹胀起病，C型患者常伴有黄疸、乏力、恶心、腹痛、皮肤瘙痒等症状，A、B、C三型患者多以低蛋白血症和自发性腹膜炎为主要并发症。A、B、C三型患者的白蛋白(Alb)水平差异均有统计学意义(P<0.05),A型患者和C型患者的血小板计数(PLT)、血红蛋白(Hb)、血清钠(Na+)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、纤维蛋白原(FIB)水平差异有统计学意义(P均<0.05)。结论 本资料中的177例HBV-ACLF患者主要以A、C两型为主，多发于夏秋两季。不同分型的HBV-ACLF患者在临床特征及生化指标方面存在差异。
Abstract：Objective To explore the clinical characteristics of 177 patients with hepatitis B virus related acute-on-chronic liver failure(HBV-ACLF) in different subtypes. Methods The medical records of 177 patients with HBV-ACLF admitted in the hospital from January 2018 to December 2021 were retrospectively analyzed, and the clinical characteristics and test indicators related to prognosis of the patients were analyzed. Results Among 177 patients, there were 64 cases of type A(36.1%), 7 cases of type B(4.0%), and 106 cases of type C(59.9%). The ratio of male and female was 4.71∶1. The average age was(42±11) years old. The age of onset of the patients were concentrated in 36 to 55 years old. Type A and B patients suffered from jaundice, fatigue, nausea, and abdominal distension. Type C patients had symptoms of jaundice, fatigue, nausea, abdominal pain, and skin itching. Hypoproteinemia and spontaneous peritonitis were the main complications in type A, B and C patients. There were statistically significant differences in albumin(Alb) among the patients with type A, B and C(P<0.05). There were significant differences in platelet count(PLT), hemoglobin(Hb), serum sodium(Na+), aspartate transaminase(AST), alanine transaminase(ALT) and fibrinogen(FIB) between type A and type C(all P<0.05). Conclusion The 177 cases of HBV-ACLF in this data are mainly of type A and type C, and most of the cases occur in summer and autumn. There are differences in clinical characteristics and biochemical indicators among different types of HBV-ACLF patients.
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基本信息:
中图分类号:R512.62;R575.3
引用信息:
[1]谢忻汝,张峰波,于明凯,等.177例乙肝相关慢加急性肝衰竭的临床特征分析[J].新疆医科大学学报,2023,46(02):159-164.
基金信息:
新疆维吾尔自治区科技援疆计划(2022E02061); 国家自然科学基金(82060115)
2023-02-15
2023-02-15