论文部分内容阅读
目的探讨影响肝硬化患者预后的主要指标。方法对1995年12月～2005年12月住院肝硬化患者278例进行回顾性分析。记录患者的血气、电解质、肝功能、Child-pugh分级等实验室资料。采用χ2和t检验和非参数检验进行单因素分析,COX回归进行多因素分析。结果单因素分析显示Child-pugh分级、氧分压、氧饱和度、谷丙转氨酶(ALT)、直接胆红素(DBIL)、间接胆红素(IBIL)等与肝硬化患者预后相关(P<0.05)。COX回归显示年龄OR为1.024(1.001～1.047)、pH值OR为0.493(0.213～1.138)、二氧化碳分压OR为0.402(0.218～0.741)、标准碳酸氢盐OR为1.194(1.033～1.380)、氧饱和度OR为0.973(0.954～0.993)、直接胆红素OR为1.004(1.001～1.007)为影响肝硬化患者预后的主要指标。结论影响肝硬化患者预后的指标为体内的酸碱平衡,如pH、二氧化碳分压、标准碳酸氢盐、氧饱和度;另外,肝功能指标直接胆红素也对预后有一定影响。
Objective To explore the main indicators affecting the prognosis of patients with liver cirrhosis. Methods A retrospective analysis of 278 inpatients with cirrhosis from December 1995 to December 2005 was performed. Record the patient’s blood gas, electrolytes, liver function, Child-pugh classification and other laboratory data. Univariate analysis using χ2 and t-test and nonparametric test, multivariate analysis of COX regression. Results Univariate analysis showed that Child-pugh classification, partial pressure of oxygen, oxygen saturation, alanine aminotransferase (ALT), direct bilirubin (DBIL), indirect bilirubin (IBIL) 0.05). COX regression showed that age OR was 1.024 (1.001-1.047), pH was 0.493 (0.213-1.138), carbon dioxide partial pressure OR was 0.402 (0.218-0.741), standard bicarbonate OR was 1.194 (1.033-1.380), oxygen The OR of saturation was 0.973 (0.954-0.993). The direct bilirubin OR was 1.004 (1.001-1.007), which was the main index of prognosis in cirrhotic patients. Conclusion The prognostic indicators of patients with cirrhosis are acid-base balance, such as pH, partial pressure of carbon dioxide, standard bicarbonate and oxygen saturation. In addition, direct bilirubin, a marker of liver function, also has an impact on prognosis.