文章摘要
肝硬化腹水患者的临床特征及预后影响因素分析
Analysis of clinical characteristics andprognostic risk factors of patients with liver cirrhotic ascites
  
DOI:10.3969/j.issn.1007-8134.2023.03.07
中文关键词: 肝硬化  腹水  炎症指标  独立危险因素
英文关键词: liver cirrhosis  ascites  inflammatory biomarkers  risk factors
基金项目:首都卫生发展科研专项(首发2020-3-7022)
作者单位
袁文芳 石家庄市第五医院感染二科 
魏?峰 石家庄市第五医院感染二科 
岳鑫彦 石家庄市第五医院感染二科 
黄?涛 石家庄市第五医院感染二科 
李志锁 高邑县医院重症医学科 
裴艳涛 石家庄市第五医院感染二科 
张?倩 石家庄市第五医院感染二科 
郝月茗 石家庄市第五医院感染二科 
戴二黑 石家庄市第五医院感染二科 
闫会敏 石家庄市第五医院感染二科 
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中文摘要:
      目的?分析影响肝硬化腹水患者预后的危险因素及其预测价值,为改善患者预后提供参考。方法?回顾性分析2020年8—12月于石家庄市第五医院住院且病例资料完整的136例诊断为肝硬化腹水的患者临床信息,并根据患者治疗2周后临床症状改善情况将患者分为好转组和未好转组。对2组患者的临床基本信息及实验室检测资料进行对比,从中选出差异有统计学意义的变量进行Logistic回归分析评估影响患者预后的危险因素、并采用ROC曲线判断其对预后的诊断价值。结果?未好转组患者的腹腔感染率明显高于好转组,白细胞计数和中性粒细胞比率也明显高于未好转组。另外,中性粒细胞/淋巴细胞比值、单核细胞/淋巴细胞比值、血小板/淋巴细胞比值在未好转组明显增高。在生化指标方面,未好转组丙氨酸氨基转移酶、门冬氨酸氨基转移酶(aspartate aminotransferase, AST)、尿素氮、碱性磷酸酶、谷氨酰转移酶、总胆红素、直接胆红素和C反应蛋白均高于好转组。Logistic回归分析显示白细胞计数、AST和尿素氮是影响肝硬化预后的独立危险因素,3者对预后预测的AUC分别为0.721、0.784和0.655。结论?肝硬化腹水患者外周血中的白细胞、AST和尿素氮水平对于其疾病的预后评判具有较高的临床预测价值。
英文摘要:
      Objective To analyze the risk factors affecting the prognosis of patients with liver cirrhosis ascites, so as to provide reference for improving the prognosis of patients. Methods?A total of 136 liver cirrhosis ascites patients with complete hospitalization data were collected from August 2020 to December 2020. All the patients were divided into improved group and non-improved group according to the prognosis. The clinical characteristics data and laboratory test data of the 2 groups of patients were compared. Statistically significant variables were selected and multivariate logistic regression analysis was performed to analyze the prognostic-related risk factors. The receiver operating characteristic (ROC) curve was used to observe the prognostic diagnostic efficiency. Results?The infection rate of the improved group was significantly lower than that of the non-improved group. There were significant differences in white blood cell count and neutrophil ratio between the 2 groups. In addition, the neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio and platelet/lymphocyte ratio were significantly higher in the non-improved group. In terms of biochemical indexes, alanine aminotransferase, aspartate aminotransferase (AST), urea nitrogen, alkaline phosphatase, glutamyltransferase, total bilirubin, direct bilirubin and CRP in the non-improved group were higher than those in the improved group, and there were significant differences between the 2 groups. Logistic regression analysis showed that white blood cell count, AST, and urea nitrogen levels were independent prognostic factors in patients with liver cirrhosis ascites. The area under the ROC curve was 0.721, 0.784 and 0.655, respectively. Conclusion?Monitoring leukocyte, AST and urea nitrogen levels is of high clinical prognostic value in patients with liver cirrhosis ascites.
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