儿童急性肝功能衰竭短期预后的影响因素

Short-term prognostic factors in children with acute liver failure

摘要:

目的 探讨影响急性肝功能衰竭患儿短期(6个月)预后的影响因素.方法 回顾性分析2008年6月至2013年9月间53例急性肝功能衰竭患儿的临床资料.53例患儿根据预后分为存活组(21例)和死亡组(32例),比较两组间肝功能指标及相关并发症等情况的不同,并进行logistic多因素回归分析筛选影响短期预后的主要影响因素.结果 死亡组和存活组患儿国际标准化比值、血氨、血清白蛋白及并发症肝性脑病、消化道出血、多器官功能衰竭等指标比较差异有统计学意义(P<0.05).多因素logistic回归分析显示血清白蛋白、INR及并发肝性脑病是急性肝功能衰竭短期预后的主要影响因素(OR分别为0.616、75.493、1210.727,P<0.05).结论 INR、并发肝性脑病、血清白蛋白是影响儿童急性肝功能衰竭短期预后的主要影响因素.

Abstract:

Objective To investigate the factors that influence the short-term (6 months) prognosis in children with acute liver failure. Methods The clinical information of 53 children with acute liver failure treated between June 2008 and September 2013 was retrospectively analyzed. The patients were divided into survival group (n=21) and death group (n=32) according to their outcomes. The liver function parameters and incidence of complications were compared between the two groups, and multivariate logistic regression analysis was used to identify major factors affecting the short-term prognosis in these patients. Results There were significant differences between the death and survival groups in the indices of international normalized ratio (INR), blood ammonia and serum albumin (Alb), and complications such as hepatic encephalopathy, gastrointestinal hemorrhage, and multiple organ failure (P<0.05). Multivariate logistic regression analysis demonstrated that serum Alb, INR, and hepatic encephalopathy were the major factors affecting the short-term prognosis of acute liver failure (OR=0.616, 75.493 and 1210.727 respectively; P<0.05). Conclusions INR, hepatic encephalopathy and serum Alb are the major factors that influence the short-term prognosis in children with acute liver failure.