本文選題：南昌地區(qū) + 急性肝衰竭　； 參考：《中國現(xiàn)代醫(yī)學雜志》2017年01期

【摘要】：目的分析江西省南昌地區(qū)急性肝衰竭(ALF)的病因和臨床特點,并且探討終末期肝病模型(MELD)評分在評估ALF預(yù)后中的價值。方法選取2006年1月-2014年12月該院收治的南昌地區(qū)47例成年ALF患者的臨床資料進行回顧性分析,包括病因、臨床特征、治療方法和轉(zhuǎn)歸等。結(jié)果導(dǎo)致南昌地區(qū)ALF的病因以乙型肝炎病毒(HBV)感染最為常見,占本組患者的40.4%(19/47),其次為藥物引起10例(21.3%),其中抗結(jié)核藥引起4例,中草藥引起3例,抗腫瘤藥引起2例,解熱鎮(zhèn)痛藥引起1例;HBV+戊型肝炎病毒重疊感染3例(6.4%),妊娠急性脂肪肝1例,熱射病2例,毒蕈中毒2例,病因不明5例(10.6%)。本組患者死亡34例,病死率為72.3%。ALF存活組與死亡組在血清白蛋白、總膽紅素、凝血酶原時間、甲胎蛋白、血氨、MELD等比較,差異有統(tǒng)計學意義(P0.05),MELD評分越高,病死率亦越高,但谷丙轉(zhuǎn)氨酶、谷草轉(zhuǎn)氨酶間比較,差異無統(tǒng)計學意義(P0.05)。入院時MELD評分受試者工作特征曲線下面積為0.881,當取Cut-off值為30.2分時,把47例患者分為MELD評分≤30.2和30.2分兩組,兩組病死率比較,MELD評分≤30.2分組的病死率較低。結(jié)論南昌地區(qū)HBV感染是導(dǎo)致ALF的首要原因,MELD評分對評估ALF的預(yù)后有一定價值。
[Abstract]:Objective to analyze the etiology and clinical features of acute hepatic failure (ALF) in Nanchang area of Jiangxi province and to evaluate the value of meld score in evaluating the prognosis of ALF. Methods the clinical data of 47 patients with adult ALF in Nanchang from January 2006 to December 2014 were retrospectively analyzed, including etiology, clinical features, treatment methods and outcome. Results Hepatitis B virus (HBV) infection was the most common cause of ALF in Nanchang area, accounting for 40.4% (19 / 47) of the patients, followed by 10 cases (21.3%) caused by drugs, including 4 cases caused by anti-tuberculosis drugs, 3 cases by Chinese herbal medicine and 2 cases by anti-tumor drugs. There were 3 cases (6.4%) of hepatitis E virus superinfection caused by antipyretic analgesics, 1 case of acute fatty liver of pregnancy, 2 cases of heat radiation, 2 cases of fungotoxicity, 5 cases (10.6%) of unknown etiology. 34 patients died, the mortality was 72.3%. The higher the score of meld, the higher the mortality of ALF, the higher the serum albumin, total bilirubin, prothrombin time, alpha-fetoprotein, ammoid meld, etc. But there was no significant difference between alanine aminotransferase and alanine aminotransferase (P0.05). At admission, the area under the operating characteristic curve was 0.881. When Cut-off value was 30.2, 47 patients were divided into two groups: meld 鈮，

本文編號：2060281