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目的分析慢加急性肝衰竭(ACLF)患者发生全身炎症反应综合征(SIRS)的常见诱因,探讨SIRS与ACLF临床转归的关系。方法回顾性分析493例ACLF患者的临床资料。按是否合并SIRS分为SIRS组(282例)和非SIRS组(211例),分析SIRS的发病诱因及临床转归;应用Logistic回归分析观察不同诱因对预后的影响。结果 ACLF患者SIRS发生率57.20%。引起SIRS最常见诱因为感染和消化道出血,且与预后明显相关(OR分别为4.355和3.557,P<0.05)。SIRS严重者,病死率高(P<0.05)。结论感染与消化道出血是ACLF发生SIRS的最常见诱因,且是影响预后的独立危险因素。
Objective To analyze common causes of systemic inflammatory response syndrome (SIRS) in patients with acute and chronic liver failure (ACLF) and to investigate the relationship between SIRS and clinical outcome of ACLF. Methods The clinical data of 493 ACLF patients were retrospectively analyzed. SIRS patients were divided into SIRS group (282 cases) and non-SIRS group (211 cases) according to whether SIRS was merged or not. The causes and clinical outcomes of SIRS were analyzed. Logistic regression analysis was used to observe the influence of different causes on prognosis. Results The incidence of SIRS in ACLF patients was 57.20%. The most common causes of SIRS were infection and gastrointestinal bleeding, and were significantly associated with the prognosis (OR, 4.355 and 3.557, respectively, P <0.05). Severe SIRS, high mortality (P <0.05). Conclusion Infection and gastrointestinal bleeding are the most common causes of SIRS in ACLF and are independent risk factors for prognosis.