乙型肝炎肝硬化和慢加急性肝衰竭患者并发感染影响因素与预后分析*

doi:10.3969/j.issn.1672-5069.2024.06.023

Abstract

Abstract: Objective The aim of this study was to investigate influencing factors of infections in patients with hepatitis B-induced liver cirrhosis (LC) and acute-on-chronic liver failure (ACLF). Methods 323 patients with hepatitis B-induced LC, 124 patients with ACLF type A (with underlying chronic hepatitis B) and 184 patients with ACLF type B (with underlying compensated LC) were encountered in our hospital during last eight years. Multivariate Logistics regression analysis was applied for influencing factors of infections, and Kaplan-Meier curves were used for 90-day survival analysis. Results Incidences of infections in patients with LC, with ACLF type A and ACLF type B were 31.0%, 32.1% and 44.0%, with spontaneous bacterial peritonitis more common; age older, serum albumin level decreased, total serum bilirubin (TSB) level and prothrombin time international standardized ratio increased, incidence of hepatic encephalopathy and gastrointestinal hemorrhage (GIH) increased in patients with infections no matter in which groups(P＜0.05); Logistics regression analysis showed that age, TSB, and GIH were all the independent risk factors for infections, while serum albumin level was a protective one; fatality rate in patients with LC was 16.0%, not significantly different compared to 15.2% in those without infection(P>0.05), while they were 57.5% in those with ACLF type A and 65.4% in with ACLF type B, both significantly higher than 14.3% and 27.2% (P＜0.05) in patients without infections; survival curve analysis showed that survival rate in HBV-ACLF type A patients without infection was 5.713 times higher than in patients with infection, and survival rate in HBV-ACLF type B patients without infection was 3.364 times higher than in those with infection. Conclusion Patients with HBV-induce LC and ACLF have higher risk of infection, and we should take risk factors into consideration in clinical practice, which might improve outcomes of them.

Key words: Liver cirrhosis, Acute-on-chronic liver failure, Infection, Influencing factors, Prognosis

Dong Xu, Qin Yanghua, Liao Wei, et al. Influencing factors of infections in patients with hepatitis B-induced liver cirrhosis and acute-on-chronic liver failure[J]. Journal of Practical Hepatology, 2024, 27(6): 891-894.

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Influencing factors of infections in patients with hepatitis B-induced liver cirrhosis and acute-on-chronic liver failure

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