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目的 分析影响慢性重型肝炎 (慢重肝 )预后的单因素。方法 使用SPASS及STATA软件 ,对 5 2 0例慢重肝预后的单因素进行分析。结果 ①≥ 4 0岁患者的病死率明显升高 ,差异有非常显著性 (P <0 .0 0 1) ,男、女患者及不同变重的基础患者的病死率差异无显著性 (P >0 .0 5 ) ;②白细胞(WBC)≥ 10 .0× 10 9 L或血小板 <10 0× 10 9/L患者的病死率明显升高 ;③随着AST ALT的比值与血清总胆红素 (TBil)不断升高、出现酶胆分离现象、凝血酶原活动度 (PTA)、血清总胆固醇 (Tc)、血清胆碱酯酶活力及白蛋白 (Alb)不断降低 ,病死率逐渐上升 ;④随着腹水、电解质紊乱及自发性腹膜炎等并发症的增多 ,病死率升高 ,以上在统计学上差异均有非常显著性。结论 ≥ 4 0岁、WBC≥ 10 .0× 10 9/L、血小板 <10 0× 10 9/L、AST ALT的比值、TBil、酶胆分离现象、PTA、Tc、血清胆碱酯酶活力、Alb及并发症等是影响慢重肝预后的重要因素 ,动态监测TBil、PTA、Tc和胆碱酯酶等实验室指标 ,积极防治各类并发症是降低病死率重要措施。
Objective To analyze the single factor affecting the prognosis of chronic severe hepatitis (chronic severe hepatitis). Methods Using SPASS and STATA software, a single factor analysis of 520 cases of chronic severe hepatitis was performed. Results ①The mortality rate in patients ≥40 years old was significantly higher than that in the control group (P <0.01). There was no significant difference in the case fatality rates between male and female patients and those with different weight gain (P> 0.05); ②The mortality of patients with white blood cell (WBC)> 10 × 10 9 L or platelets <10 × 10 9 / L was significantly increased; ③As the ratio of AST ALT and serum total bilirubin (TBil) increased continuously, and enzyme-biliary separation, PTA, Tc, Alb and serum Alb were continuously decreased; ④ With ascites, electrolyte imbalance and spontaneous peritonitis and other complications increased, mortality increased, the above statistical differences were very significant. CONCLUSIONS: ≥40 years old, WBC≥10.0 × 10 9 / L, platelet count <10 × 10 9 / L, AST ALT ratio, TBil, enzyme-biliary separation, PTA, Tc, serum cholinesterase, Alb and complications are important factors affecting the prognosis of chronic severe hepatitis. Dynamic monitoring of laboratory indexes such as TBil, PTA, Tc and cholinesterase, and active prevention and treatment of various complications are important measures to reduce mortality.