急性肝不全の病因,臨床的表れ,成人のアウトカム:カラチの第三次医療病院の経験

Nazish Butt¹, Sabir Ali², Hanisha Khemani²

¹Department of Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi 05444, Pakistan. dr.nazishbutt@gmail.com.

World journal of critical care medicine

|August 29, 2025

まとめ

急性肝不全 (ALF) は,特に妊婦の死亡率が高い. 肝炎Eウイルスの感染,肝臓脳病 (HE) の重症度,および症は,ALF患者の死亡率に寄与する重要な要因です.

科学分野:

ヘパトロジー
胃腸内科
クリティカルケア医療

背景:

急性肝不全 (ALF) は,病因,年齢,社会経済的地位を含む様々な要因によって影響を受けます.
ALFのアウトカムは,病因,凝血症,ビリルビン濃度,年齢,肝臓脳病 (HE) の重度によって予測され,昏睡状態と死亡率を予測するのに役立ちます.

研究の目的:

ALFで入院した成人の患者の原因,臨床的特徴,アウトカムとの関連を調べる.
社会経済的な地位と様々なALFの成果との関係を分析する.

主な方法:

カラチのジンナ大学院医療センターの成人ALF患者102人を対象とした前向きな横断研究 (2019年7月 - 2022年12月).
年齢,HEグレード,ビリルビン,プロトロンビン時間,INR,クレアチニン,病因を含むキングズ・カレッジの基準に基づく診断.
SPSS v26.0を用いた統計分析で,社会経済的な地位と結果の関連性を評価するキ2テスト (p < 0.05) が実施された.

主要な成果:

コホートの平均年齢は27. 37 ± 6. 60歳; 69. 6%が女性で, 77. 5%が妊娠していた (平均妊娠年齢は34. 56 ± 3. 80週間).
HEグレードIIIとIIは,それぞれ44. 1%と12. 7%の患者で観察されました.
ICU患者では72. 9%の死亡率と43. 8%の回復率を記録した.

結論:

高等医療病院で治療を受けたALF患者では高い死亡率が見られた.
肝炎Eウイルスの感染,肝炎の重症度,および結血症は,ALF患者における死亡率の増加と有意に関連していた.

キーワード:

急性肝障害肝臓脳症肝炎Eウイルス黄死亡率

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