Objective To determine the factors affecting prognosis of hepatitis B virus (HBV) -related acute-on-chronic liver failure (ACLF) with Qi-deficiency and blood-stasis jaundice.Methods Seventy-four patients diagnosed with HBV-related ACLF and having Qi-deficiency and blood-stasis jaundice were identified for retrospective analysis and divided into two groups according to outcome: improvement (n = 25) or death (n = 49) .Patient age, days between attack and treatment, clinical symptoms and signs score, and related biochemical indexes (prothrombin activity, PTA;total cholesterol, TCH;total bilirubin, TBil) were assessed for correlation with prognosis by using logistic regression.Results There was no correlation between patients' age and prognosis (improvement group vs.death group, P > 0.05) .The period of days between attack and treatment was significantly longer for the improvement group than for the death group (P < 0.01) and logistic regression analysis indicated that the days between attack and treatment was negatively associated with prognosis.The scores for symptoms of anorexia, hypodynamia, and ecchymosis were lower in the improvement group than in the death group;in general, higher scores accompanied worse prognosis.According to logistic regression analysis, PTA, TCH, and TBil were significantly worse in the death group, with the TBIL being much higher and the PTA and TCH levels being lower than in the improvement group.Conclusion Prognostic factors of HBV-related ACLF with Qi-deficiency and blood-stasis jaundice include days between attack and treatment, anorexia, hypodynamia, ecchymosis, and related biochemical indexes.
[1]中华医学会感染病学分会肝衰竭与人工肝学组、中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊疗指南[J].中华内科杂志, 2006, 45 (12) :1053-1056.
|
[2]张涛, 孙克伟.中医治疗乙型肝炎相关性肝衰竭的经验与进展[J].临床肝胆病杂志, 2012, 28 (3) :169-171.
|
[3] 李筠.慢性重型肝炎证候规律及中西医结合治疗方案研究报告∥第二十次全国中西医结合肝病学术会议论文集[C].2011:27-29.
|
[4]彭杰, 陈斌, 孙克伟.慢性乙型重型肝炎“湿热-血瘀-脾虚”证候分布与演变特点的回顾性分析[J].中西医结合肝病杂志, 2011, 21 (3) :135-138.
|
[5]周意, 贺希, 孙克伟.慢性乙型重型肝炎中医证候与临床分期相关性研究[J].中医药导报, 2010, 16 (5) :39-40.
|
[6]王柯心, 关卫兵, 戴敏, 等.慢性乙型重型肝炎不同分期的中医证候规律研究[J].传染病信息, 2010, 23 (5) :266-269.
|
[7]胡建华, 钱英, 姚乃礼, 等.“截断逆挽法”治疗慢性乙型重型肝炎临床疗效观察[J].中西医结合肝病杂志, 2010, 20 (4) :200-203.
|
[8]刘君颖, 赵文霞.赵文霞治疗慢性重型肝炎经验[J].中医杂志, 2011, 52 (1) :66-67.
|
[9]张赤志, 田德英.中西医结合肝脏病学[M].北京:人民军医出版社, 2002:152.
|
[10]唐荣国, 孙皆齐.肝衰竭预后与不同因素关系探讨[J].疑难病杂志, 2011, 10 (10) :777-778.
|
[11]Jang ES, Won JE, Jung JI, et al.The effect of antiviral ther-apy on serum cholesterol levels in chronic hepatitis C[J].Gut Liver, 2011, 5 (3) :356-362.
|
[12]Cicognani C, Malavolti M, Morselli-Labate AM, et al.Ser-um lipid and lipoprotein patterns in patients with liver cirrhosisand chronic active hepaitis[J].Arch Intern Med, 1997, 157 (7) :792-796.
|
[13]杨波, 吴元凯, 陈忠诚, 等.ALT、AST、TBil及PT变化趋势与慢加急性乙型肝炎肝衰竭预后的关系[J].临床肝胆病杂志, 2012, 28 (3) :205-208.
|
[14]张强, 孙凤霞.79例亚急性肝衰竭患者的临床分析[J].临床肝胆病杂志, 2012, 28 (1) :53-54.
|