摘要
,MELD指标差异具有统计学意义(P<0.05).C级患者更易出现腹水、肝性脑病和感染.MELD评分20分以上27例(93.1%),多数在20～40分之间.不同MELD组间TB,INR,Cre,Child-pugh评分存在显著差异(P<0.05).MELD评分越高越易发生肝性脑病.29例患者随访1 mo全部死亡.结论:1型HRS患者死亡率极高,应根据临床生化指标及肝功能分级综合判断其预后,做到早诊断,早治疗,以改善预后.
Abstract
AIM: To analyze the causes, inducing factors and clinical indicators of type 1 hepatorenal syndrome (HRS) in hope of a better understanding of the disease. METHODS: In the review of 29 type 1 HRS patients treated in our hospital from January. 2000 to August. 2008, related data, inducing factors, TB, ALB, INR, Cre, Na+, Child-pugh, MELD scores, urine volume and survival rates, were collected and analyzed. RESULTS: Type 1 HRS mainly occurred in patients of late cirrhosis and severe hepatitis. Child-pugh scores were Level B and above, mainly Level C (82.76%). TB, INR, ALB and MELD varied greatly between Level B and Level C(P ＜ 0.05). Level C patients were more likely to suffer from ascites, hepatic encephalopathy and infection. Of the 29 patients, MELD scores of 27 patients(93.1%)were above 20 points, mainly between 20 and 40 points, while TB, INR, Cre and Child-pugh scores varied greatly among groups of different MELD(P ＜ 0.05). The higher a MELD score was, the more likely the patient was to have hepatic encephalopathy. All the 29 patients died within 1 month. CONCLUSION: The mortality rate of type 1 HRS patients is very high. A comprehensive prognosis can be judged by clinical characters, biochemical indicators and liver function classification. An improved prognosis can be expected when type 1 HRS patients are early diagnosed and treated.
基金项目
重庆市科学技术委员会自然科学基金(CSCY2005BB5311)
NETL
NSTL
维普
万方数据