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Clinics ; Clinics;72(11): 686-692, Nov. 2017. tab, graf
Article de Anglais | LILACS | ID: biblio-890692

RÉSUMÉ

OBJECTIVE: To investigate the impact of the baseline status of patients with hepatitis B virus-associated acute-on-chronic liver failure on short-term outcomes. METHODS: A retrospective study was conducted that included a total of 138 patients with hepatitis B virus-associated acute-on-chronic liver failure admitted to the Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, from November 2013 to October 2016. The patients were divided into a poor prognosis group (74 patients) and a good prognosis group (64 patients) based on the disease outcome. General information, clinical indicators and prognostic scores of the patients' baseline status were analyzed, and a prediction model was established accordingly. RESULTS: Elder age, treatment with artificial liver support systems and the frequency of such treatments, high levels of white blood cells, neutrophils, neutrophil count/lymphocyte count ratio, alanine aminotransferase, gamma-glutamyl transferase, total bilirubin, urea, and prognostic scores as well as low levels of albumin and sodium were all significantly associated with the short-term outcomes of hepatitis B virus-associated acute-on-chronic liver failure. The predictive model showed that logit (p) = 3.068 + 1.003 × neutrophil count/lymphocyte count ratio - 0.892 × gamma-glutamyl transferase - 1.138 × albumin - 1.364 × sodium + 1.651 × artificial liver support therapy. CONCLUSION: The neutrophil count/lymphocyte count ratio and serum levels of gamma-glutamyl transferase, albumin and sodium were independent risk factors predicting short-term outcomes of hepatitis B virus-associated acute-on-chronic liver failure, and the administration of multiple treatments with artificial liver support therapy during the early stage is conducive to improved short-term outcomes.


Sujet(s)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Insuffisance hépatique aigüe sur chronique/virologie , Hépatite B/complications , Pronostic , Valeur prédictive des tests , Études rétrospectives , Facteurs de risque , Sensibilité et spécificité , Insuffisance hépatique aigüe sur chronique/mortalité , Insuffisance hépatique aigüe sur chronique/sang , Insuffisance hépatique aigüe sur chronique/thérapie , Hépatite B/mortalité , Hépatite B/sang , Hépatite B/thérapie
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