肝性脑病患者的预后影响因素分析

崔燕平; 李庆方; 李庆彦; 刘春华; 王伟红; 袁建国; 王思奎

doi:10.3969/j.issn.1001-5256.2016.01.026

肝性脑病患者的预后影响因素分析

DOI: 10.3969/j.issn.1001-5256.2016.01.026

聊城市人民医院

详细信息

中图分类号: R575.3
计量
- 文章访问数: 2167
- HTML全文浏览量: 50
- PDF下载量: 418
- 被引次数: 0
出版历程
- 收稿日期: 2015-05-11
- 出版日期: 2016-01-20

Logistic regression analysis of prognostic risk factors for hepatic encephalopathy

Liaocheng People's Hospital

摘要

摘要:
目的对影响肝性脑病（HE）患者预后的因素进行分析,探讨影响预后的危险因素。方法回顾性分析2006年1月-2014年6月在聊城市人民医院接受治疗的HE患者385例,分为好转组（125例）和恶化组（260例）,选择25个相关临床指标,应用SPSS对相关数据进行非条件二分类反应变量Logistic回归分析。结果经单因素分析,HE分期、上消化道出血、肝肾综合征（HRS）、TBil、国际标准化比值（INR）为影响HE预后的危险因素（P值分别为0.000、0.009、0.047、0.002、0.027）。进一步将有意义的变量进行多因素Logistic回归分析,HE分期、上消化道出血、HRS、TBil、INR为影响HE预后的独立危险因素[P值分别为0.000、0.009、0.000、0.000、0.008,比值比（95%可信区间）分别为4.388（2.9976.424）、2.805（1.3006.050）、4.036（2.0188.072）、1.005（1.0031.007）、1.446（1.0991<...
- 肝性恼病 /
- 预后 /
- 危险因素 /
- 回归分析
Abstract:
Objective To analyze the prognostic risk factors for hepatic encephalopathy( HE),and to explore the risk factors for prognosis.Methods A total of 385 patients with HE who were treated in Liaocheng People's Hospital from January 2006 to June 2014 were enrolled in this study and analyzed retrospectively. These patients were divided into improved group( n = 125) and deteriorated group( n = 260). A total of 25 clinical indices were selected,and non- conditional binary logistic regression analysis was performed for related data with SPSS.Results Univariate analysis showed that HE stage,upper gastrointestinal hemorrhage,hepatorenal syndrome( HRS),total bilirubin( TBil),and international normalized ratio( INR) were risk factors affecting the prognosis of HE( P = 0. 000,0. 009,0. 047,0. 002,and0. 027,respectively). Multivariate logistic regression analysis was further performed for the variables with statistical significance and the results showed that HE stage,upper gastrointestinal hemorrhage,HRS,TBil,and INR were independent risk factors affecting the prognosis of HE( P = 0. 000,0. 009,0. 000,0. 000,and 0. 008,respectively; OR( 95% CI) = 4. 388( 2. 997- 6. 424),2. 805( 1. 300- 6. 050),4. 036( 2. 018- 8. 072),1. 005( 1. 003- 1. 007),and 1. 446( 1. 099- 1. 901),respectively). Conclusion HE stage,upper gastrointestinal hemorrhage,HRS,TBil,and INR are risk factors affecting the prognosis of HE,and advanced HE stages,a high level of bilirubin,high INR,and presence of upper gastrointestinal hemorrhage and HRS indicate poor prognosis. The patient's HE stage,upper gastrointestinal hemorrhage,HRS,TBil,and INR are applied as the indices for prognosis of HE,and the equation based on the these indices may have a reference value in clinical practice.
- hepatic encephalopathy /
- prognosis /
- risk factors /
- regression analysis

HTML全文

参考文献(12)

[1]SHI YY,CUL JG.Progresses of MRI in hepatic encephalopathy[J].Chin J Med Imaging Technol,2014,30(2):291-294.(in Chinese)史勇跃,崔进国.肝性脑病的MR研究进展[J].中国医学影像技术,2014,30(2):291-294.

[2]Expert Committee on the Diagnosis and Treatment of Hepatic Encephalopathy.Expert consensus on the diagnosis and treatment of hepatic encephalopathy[J/CD].Chin J Exp Clin Infect Dis:Electronic Edition,2009,3(4):449-473.(in Chinese)肝性脑病诊断治疗专家委员会.肝性脑病诊断治疗专家共识[J/CD].中华实验和临床感染病杂志:电子版,2009,3(4):449-473.

[3]YU YH,JIANG JN,WU JZ,et al.Logistic regression analysis of prognostic factors for patients with hepatic encephalopathy[J].Chin J Infect Dis,2009,27(5):305-307.(in Chinese)玉艳红,江建宁,吴继周,等.肝性脑病患者预后影响因素的Logistic回归分析[J].中华传染病杂志,2009,27(5):305-307.

[4]HAUSSINGER D,SCHLIESS F.Pathogenetic mechanisms of hepatic encephalopathy[J].Gut,2008,57(8):1156-1165.

[5]LYU RY,LI SX.Study on the risk factors influencing the prognosis of hepatic encephalopathy[J].Chin J Gen Prac,2012,10(11):1687-1688.(in Chinese)吕日英,李仕雄.肝性脑病患者预后的危险因素分析[J].中华全科医学,2012,10(11):1687-1688.

[6]NIE X,HE Y,LI GX,et al.Research on relationship between hepatorenal syndrome and hepatic encephalopathy[J].Chin J Lab Diag,2012,16(3):475-478.(in Chinese)聂鑫,贺勇,李贵星,等.肝肾综合征与肝性脑病的关系研究[J].中国实验诊断学,2012,16(3):475-478.

[7]DING JB,LUO XL,TIAN YM,et al.Logistic regression analysis of prognostic factors for chronic severe hepatitis B[J].Infect Dis Info,2012,25(3):161-163.(in Chinese)丁剑波,罗晓岚,田一梅,等.慢性乙型重型肝炎预后影响因素Logistic回归分析[J].传染病信息,2012,25(3):161-163.

[8]YE PY,YANG ZG,CHEN XR,et al.Risk factors associated with prognosis of progressive stages of acute-on-chronic hepatitis B liver failure[J].J Clin Hepatol,2013,29(4):270-275.(in Chinese)叶佩燕,杨宗国,陈晓蓉,等.HBV相关慢加急性肝衰竭不同分期的预后评价及影响因素分析[J].临床肝胆病杂志,2013,29(4):270-275.

[9]CHEN DF,SUN WJ.Recent advances in understanding the pathogenesis of hepatic encephalopathy[J].Chin J Hepatol,2014,22(2):84-85.(in Chinese)陈东风,孙文静.肝性脑病发病机制的研究进展[J].中华肝脏病杂志,2014,22(2):84-85.

[10]KHUNGAR V,POORDAD F.Hepatic encephalopathy[J].Clin Liver Dis,2012,16(2):301-320.

[11]BANARES R,NEVENS F,LARSEN FS,et al.Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure:the relief trial[J].Hepatology,2013,57(3):1153-1162.

[12]HASSANEIN TI,TOFTENG F,BROWN RS,et al.Randomized controlled study of extracorporeal albumin dialysis for hepatic encephalopathy in advanced cirrhosis[J].Hepatology,2007,46(6):1853-1862.

施引文献

资源附件(0)

访问统计