本文選題：肝硬化 + 乙型病毒性肝炎　； 參考：《山東醫(yī)藥》2017年08期

【摘要】：目的探討乙肝肝硬化門靜脈高壓患者經(jīng)頸靜脈肝內(nèi)門體分流術(shù)(TIPS)前后門靜脈、肝靜脈血清CXCL9水平變化及其與患者預(yù)后的關(guān)系。方法選擇行TIPS的乙肝肝硬化門靜脈高壓患者80例,術(shù)后中位生存時(shí)間為293天,其中≥293天者37例,293天者43例。分析80例患者術(shù)前及術(shù)后14天相關(guān)實(shí)驗(yàn)室檢查資料,如CXCL9、膽紅素、膽堿酯酶、白蛋白、ALT、AST、γ-谷氨酰轉(zhuǎn)肽酶、國(guó)際標(biāo)準(zhǔn)化比率、血肌酐、尿素氮、血清鈉、PLT、門靜脈壓力、中心靜脈壓力、門靜脈血流速度,比較生存時(shí)間≥293天者與293天者上述指標(biāo)變化,并篩選影響患者預(yù)后的危險(xiǎn)因素。結(jié)果 80例患者術(shù)后門靜脈和肝靜脈血清CXCL9水平均低于術(shù)前(P均0.05)。單因素分析發(fā)現(xiàn),生存時(shí)間≥293天者與293天者術(shù)前門靜脈和肝靜脈血清CXCL9、Na+、血肌酐、尿素氮、膽紅素水平以及術(shù)后門靜脈壓比較P均0.05;其他相關(guān)實(shí)驗(yàn)室檢查資料比較P均0.05。多因素Cox回歸分析發(fā)現(xiàn),術(shù)前門靜脈血清CXCL9水平是患者預(yù)后的獨(dú)立影響因素(OR=0.261,95%CI為0.132~0.524,P0.01)。術(shù)前門靜脈血清CXCL9≥400 pg/m L者與400 pg/m L者平均生存時(shí)間分別為113、941天,二者比較P0.01。結(jié)論乙肝肝硬化門靜脈高壓患者TIPS術(shù)后門靜脈、肝靜脈血清CXCL9水平明顯降低;術(shù)前門靜脈血清CXCL9水平≥400 pg/m L者預(yù)后較差。
[Abstract]:Objective to investigate the changes of serum CXCL9 levels in portal vein and hepatic vein before and after tranjugular intrahepatic portosystemic shunt (tips) in patients with hepatitis B cirrhosis and its relationship with prognosis. Methods 80 patients with portal hypertension due to hepatitis B cirrhosis were treated with tips. The median survival time was 293 days, of which 37 cases were more than 293 days and 43 patients were at least 293 days. The laboratory data of 80 patients before and 14 days after operation were analyzed, such as CXCL9, bilirubin, cholinesterase, ALTAST, 緯 -glutamyl transpeptidase, international standardized ratio, serum creatinine, urea nitrogen, serum natriuretic acid, portal vein pressure. The central venous pressure, portal vein blood flow velocity, survival time 鈮，

本文編號(hào)：2105887