急性至慢性肝衰竭;流行率,原因,易感因素和结果
Kamran Bagheri Lankarani1, Zahra Ghanbarinasab2, Ramin Niknam2
1Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Gastroenterology and hepatology from bed to bench
|July 12, 2024
概括
急性至慢性肝衰竭 (ACLF) 患者的平均年龄低,死亡率高于急性去补偿 (AD) 患者. 血液动力学不稳定性和代谢性酸是ACLF的关键死亡风险因素.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
- 临界护理医学 临界护理医学
背景情况:
- 急性至慢性肝衰竭 (ACLF) 是一种复杂的综合征,死亡率高.
- 关于ACLF的患病率,原因,易感因素和结果,目前仍在进行辩论.
研究的目的:
- 调查成年肝硬化患者中ACLF的患病率,原因,易感因素和结果.
- 为了确定与急性脱补偿 (AD) 相比,与ACLF死亡率相关的风险因素.
主要方法:
- 一项横截面研究分析了156名被诊断患有ACLF或AD的成年肝硬化患者.
- 用APASL标准定义了ACLF;用EASL-CLIF和NACSELD得分评估严重程度.
- 包括考克斯回归在内的生存分析被用来确定死亡率预测因素.
主要成果:
- ACLF患者比AD患者 (62.30±14.28岁) 年轻 (56.62±16.19岁).
- 在两组中,非酒精性脂肪肝炎和感染是常见的;肝脑病和呼吸衰竭是ACLF中最常见的器官衰竭.
- 在ACLF中,死亡概率明显高 (P<0.001);低血压和降低血液pH值是显著的死亡风险因素.
结论:
- 与AD相比,ACLF与年轻的年龄和显著更高的死亡率有关.
- 非酒精性脂肪肝炎和感染是ACLF的关键因素,血液动力学不稳定性和代谢性酸性病预测死亡率.
- 在所有ACLF死亡率中观察到EASL-CLIF3级和4级严重性得分.
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