目的: 通过回顾性横断面研究探讨成年急性肝衰竭患者预后的影响因素。方法: 回顾性收集湖南省某三甲医院2020年—2023年间收治的急性肝衰竭患者的临床资料,通过t检验、卡方检验和秩和检验对血液指标进行单因素分析,再对存在差异的指标进行Logistic回归分析。结果: 139例患者中有78例患者病情好转,61例患者病情未好转。患者年龄19~79岁。单因素分析结果显示病情好转组的总胆汁酸、直接胆红素、肾小球滤过率高于病情未好转组,病情好转组的肌酐、尿酸、胱抑素C、钾、磷、凝血酶原活动度、国际标准化比值、活化部分凝血酶原低于病情未好转组。Logistic回归分析结果显示肌酐（OR=2.92,95%CI：1.13~7.54）、总胆汁酸（OR=0.23,95%CI：0.05~0.95）、国际标准化比值（OR=8.73,95%CI：2.25~33.86）是急性肝衰竭的独立影响因素。肌酐、国际标准化比值的异常升高可能会增加患者病情恶化的风险,总胆汁酸的升高可能会降低患者病情恶化的风险。结论: 肌酐、总胆汁酸、国际标准化比值是急性肝衰竭的独立影响因素。
Abstract
Objective To investigate the prognostic factors of adult patients with acute liver failure through a retrospective cross-sectional study. Methods Retrospectively collected A three armour hospital of hunan province from 2020 to 2023 were analyzed the clinical data of patients with acute liver failure. By t test and chi-square test and rank and inspection to the single factor analysis of indicators, and Logistic regression analysis was carried out on the differences of indicators. Results Among the 139 patients, 80 patients were improved and 59 patients were not improved. The age of the patients ranged from 19 to 79 years. Univariate analysis showed that the total bile acid, direct bilirubin, and glomerular filtration rate in the improved group were higher than those in the non-improved group, and the creatinine, uric acid, cystatin C, potassium, phosphorus, prothrombin activity, international standard ratio, and activated partial thromboplastin in the improved group were lower than those in the non-improved group. Logistic regression analysis showed that creatinine (OR=2.92, 95%CI: 1.13-7.54), total bile acid (OR=0.23, 95%CI: 0.05-0.95), international standard ratio (OR=8.73, 95%CI: 2.25-33.86) were the independent influencing factors for acute liver failure. The abnormal increase of creatinine and international standard ratio may increase the risk of disease deterioration, and the increase of total bile acids may reduce the risk of disease deterioration. Conclusion Creatinine ratio, total bile acid, international standard is independent impact factors for acute liver failure. Abnormal creatinine and the ratio of international standard rise may increase the risk of progression of the disease patients, patients with the increase of total bile acid could reduce the risk of deterioration.
关键词
急性肝衰竭 /
影响因素 /
Logistic回归
Key words
acute liver failure /
the influencing factors /
logistic regression
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基金
湖南省科技创新重大项目“基于北斗、5G、物联网技术开发急危重症前救治和重大传染病的应急救援指挥决策信息平台”（2020SK1015）
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