失代偿期肝硬化患者急性肾损伤相关危险因素分析-论文.pdf

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1、·360·实用肝脏病杂志2014年7月第17卷第4期JPracHepatol，Ju1．Q．．!：·肝硬化·失代偿期肝硬化患者急性肾损伤相关危险因素分析吴小倩，苏菲【摘要】目的探讨失代偿期肝硬化患者发生急性肾损伤的危险因素。方法收集254例失代偿期肝硬化伴有腹水患者的相关临床资料，以血肌酐高于正常参考值上限为标准，将研究对象分为急性肾损伤观察组和无急性肾损伤的对照组，回顾性分析入选病例基础临床资料和相关实验室指标，应用单因素和多因素分析统计学方法，分析失代偿期肝硬化发生急性肾损伤的相关危险因素。结果观察组患

2、者肝性脑病发生率为50．4％，对照组为10．1％(P<0．01)；观察组自发性细菌性腹膜炎和其他部位感染发生率分别为70．4％和32．6％，显著高于对照组的41．2％和19．3％(P<0．05)；观察组血钠、血清总胆红素和白细胞计数水平分别为128mmol／L、391．8mol／L和9．33X109／L，均显著低于或高于对照组的136．8mmol／L、51．58mol／L和3．9x10YL(P<0．05)；观察组血浆凝血酶原活动度为(34．2-I-17．3)％，显著低于对照组的(52．1±16．1)％(P

3、

4、tswitlldecompensatedlivercirrhosisWuXiaoqian．SuFei．DepartmentofInfectiousDiseases，FirstAfiliatedHospital，AnhuiMedicalUniversity，Hefei230022，AnhuiProvince，China【Abstract】ObjectiveTostudytheriskfactorsforacutekidneyinjuryinpatientswithdecompen—satedlivercir

5、rhosis．MethodsRelevantclinicaldataof254patientswithdecompensatedlivercirhosisandasciteswereretrospectivelyanalyzed．Thepatientsweredividedintoobservationgroupwithsel31mcreatininelevelsbeyondtheupperlimitofnormal(n=135)andcontrolgroupwithnormalseFilmcreati—

6、nine(n=l19)．Theriskfactorsforacutekidneyinjurywereanalyzedbyunivariateandmultivariateanalysismethods．ResetsTheincidencesofhepaticencephalopathywere50．4％inobservationgroupand10．1％incontrolgroup(P<0．O1)；theincidencesofspontaneousbacteriaperitonitis(SBP)andi

7、n—fectioninothersiteswere70．4％and32．6％inobservationgroup．significantlyhigherthaninpatientsincontrolgroup(41．2％and19．3％，respectively，P

8、ervationgroup，whichweresignificantlydiferentascomparedtothoseincontrolgroup(136．8mmol／L，51．58mol／Land3．9×109／L，respectively，P<0．01)；theplasmaprothrombintimeactivity(PTA)were(34．2±17．3)％inobservationgroupand(52．1±16．