慢加急性乙型肝炎肝衰竭患者贫血特点分析*

doi:10.3969/j.issn.1672-5069.2016.01.014

实用肝脏病杂志 ›› 2016, Vol. 19 ›› Issue (1): 55-59.doi: 10.3969/j.issn.1672-5069.2016.01.014

慢加急性乙型肝炎肝衰竭患者贫血特点分析*

季淑静, 王梦洁, 陈金军

510515 广州市南方医科大学南方医院感染内科器官衰竭防治国家重点实验室/广东省病毒性肝炎研究重点实验室

收稿日期:2015-06-10 出版日期:2016-01-10 发布日期:2016-02-04
通讯作者: 陈金军,E-mail: chjj@smu.edu.cn
作者简介:季淑静,女,23岁,大学本科,医学学士。E-mail:sandy19922010@163.com
基金资助:
*基金项目：国家自然科学基金资助项目（81270533、81470038）; “863”计划项目（2012AA022605）; 教育部博士点专项课题（20124433120016）

Prevalence of anemia in patients with acute on chronic liver failure

Ji Shujing, Wang Mengjie, Chen Jinjun

State Key Laboratory for Organ Failure Research,Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases,Nanfang Hospital, Southern Medical University,Guangzhou 510515,Guangdong Province,China

Received:2015-06-10 Online:2016-01-10 Published:2016-02-04

摘要/Abstract

摘要： 目的探索慢加急性肝衰竭患者贫血的发生、转归及对短期生存的影响。方法纳入2011年12月至2013年1月我院住院的乙型肝炎病毒感染导致的慢加急性肝衰竭患者,中心实验室常规检测血常规、血肌酐、谷丙转氨酶、谷草转氨酶、白蛋白、总胆红素、凝血功能指标等。与慢性乙型肝炎及HBV相关的肝硬化患者比较,观察慢加急性肝衰竭患者贫血的发生、转归。结果在纳入的171例肝病患者中,40例慢性乙型肝炎患者贫血发生率为2.5%,49例肝硬化患者为34.7%,82例慢加急性肝衰竭患者住院时贫血发生率为45.1%（其中 26.8%为轻度贫血,17.1%为中度贫血,1.2%为重度贫血）;慢加急性肝衰竭患者贫血程度在住院1周内加重（122.4 g/L 对112.7 g/L,P<0.001）;长期生存患者（n=42）恢复期贫血情况显著改善 (147.5 g/L 对入院时的112.7 g/L,P=0.001);住院首日血红蛋白水平（截断点125.5 g/L）是90天生存率的预测因素（曲线下面积=0.735,P<0.001）。结论慢加急性肝衰竭患者贫血发生率高,对短期生存不利,而生存者贫血情况可缓慢恢复;入院时血红蛋白水平能预测短期预后。

关键词: 慢加急性肝衰竭, 乙型肝炎, 贫血, 短期生存

Abstract: Objective To investigate the prevalence of anemia in patients with hepatitis B virus-induced acute-on-chronic liver failure（ACLF）,and to evaluate its association with short-term survivals. Methods Hospitalized patients with HBV related acute-on-chronic liver failure,cirrhosis or chronic hepatitis B were recruited from December 2011 to January 2013 in this study. The peripheral blood index were routinely assayed. The prevalence and progression of anemia and clinical outcome of patients were observed. Results There were 171 patients included in this study. 2.5% out of 40 patients with chronic hepatitis B,34.7% out of 49 patients with liver cirrhosis and 45.1% out of 72 patients with ACLF had anemia at admission;and the percentages of mild,moderate and severe anemia in patients with ACLF were 26.8%,17.1% and 1.2%,respectively;Anemia in patients with ACLF exacerbated within first hospitalization week（122.4g/L vs. 112.7g/L,P=0.001）;the blood hemoglobin levels in survived patients with ACLF（n=42） increased（112.7 g/L vs. 147.5 g/L,P=0.001）;Blood hemoglobin levels in patients with ACLF at admission（cut-off value was 125.5 g/L） was an predictor for 90-day survivals （AUROC=0.735,P<0.001）. Conclusions Anemia in patients with ACLF is common and severe,which might aggravate within one week and recover in survivals.

Key words: Acute-on-chronic liver failure, Anemia, Hepatitis B, Short-term survival

季淑静, 王梦洁, 陈金军. 慢加急性乙型肝炎肝衰竭患者贫血特点分析*[J]. 实用肝脏病杂志, 2016, 19(1): 55-59.

Ji Shujing, Wang Mengjie, Chen Jinjun. Prevalence of anemia in patients with acute on chronic liver failure[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(1): 55-59.

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慢加急性乙型肝炎肝衰竭患者贫血特点分析*

Prevalence of anemia in patients with acute on chronic liver failure

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