关键词: 重型肝炎, 预后, 危险因素, 评分系统

Abstract: The objective was to analyse multiple risk factors of predictive survive of serious virous hepatitis, and to make a scored system which could determine patient's prognosis. One hundred and seventy patients at the end of hospitalization were divided into the living group(n=45)and the dying group(n=125). Among them 133 patients were men, and 37 patients were women. The average age was 43.5 years old(range from 8 to 79). Twenty clinical and laboratory parameters were investigated as predictive risk factors.Univariate analysis was first made. Variables reaching statistical significance(P<0.05)were subsequently introduced in Logistic regression to identify the independent risk factors for patient's survival. The methods of statistical analysis were performed with SPSS for WINDOWS statistical package. Results: nine clinical and laboratory parameters, PTA, serum Na⁺, hepatic encephalopathy, clinical types of serious virous hepatitis, GI bleeding, syndrome of hepatic kidney, total bilirubin,serum BUN, and ascites were closely related to prognosis of severe type of virous hepatitis by analysis of univariate. Four independent risk factors, PTA, serum Na⁺, hepatic encephalopathy, and clinical types of serious virous hepatitis were obtained by Logistic regression. A scored system was made accroding to the 4 parameters. The threshold score of death was five. The coincidence rate was 80% by retrospective study of 170 patients with serious virous hepatitis. Conclusions: PTA, serum Na⁺, hepatic encephalopathy, and clinical types of serious virous hepatitis are independent predictive factors in patients with serious virous hepatitis. It is important that the risk factors should be assessed, ward off, and treated as early as possible. The treatment strategy can be determined and the medical resources can be reasonably used according to this score system.

Key words: severe type of virous hepatitis|prognosis|risk factor|scored system