人工肝治疗HBV相关慢加急性肝衰竭的血小板计数变化及其影响因素
目的 探究乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者接受人工肝治疗后PLT计数的变化趋势和影响因素。 方法 选取2018年1月—2021年11月在中山大学附属第三医院住院接受血浆置换治疗(n=102)和双重血浆分子吸附系统联合低剂量血浆置换(n=50)的152例HBV-ACLF患者，分析患者的临床资料和实验室指标。计量资料两组间比较采用独立样本t检验或Mann-Whitney U检验，计数资料两组间比较采用χ2检验；采用logisitic多因素分析影响人工肝治疗后PLT＞50×109/L的危险因素, 采用ROC曲线分析基线PLT计数对人工肝治疗后PLT＞50×109/L的预测价值。 结...
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| Published in | Linchuang gandanbing zazhi Vol. 38; no. 5; pp. 1053 - 1058 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
Changchun
Journal of Clinical Hepatology
01.05.2022
中山大学附属第三医院感染科,广州510635 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1001-5256 2097-3497 |
| DOI | 10.3969/j.issn.1001-5256.2022.05.015 |
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| Abstract | 目的 探究乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者接受人工肝治疗后PLT计数的变化趋势和影响因素。 方法 选取2018年1月—2021年11月在中山大学附属第三医院住院接受血浆置换治疗(n=102)和双重血浆分子吸附系统联合低剂量血浆置换(n=50)的152例HBV-ACLF患者，分析患者的临床资料和实验室指标。计量资料两组间比较采用独立样本t检验或Mann-Whitney U检验，计数资料两组间比较采用χ2检验；采用logisitic多因素分析影响人工肝治疗后PLT＞50×109/L的危险因素, 采用ROC曲线分析基线PLT计数对人工肝治疗后PLT＞50×109/L的预测价值。 结果 纳入患者以中年男性为主，70例(46.1%)患者在入院时合并肝硬化，114例(75.0%)患者接受3次人工肝治疗，基线PLT＞50×109/L患者占比为88%。总体患者人工肝治疗后PLT计数较基线水平显著下降(79.5±47.7 vs 112.5±64.1, t=4.965, P＜0.001)，治疗后1周PLT计数升高至基线水平(97.2±50.7 vs 112.5±64.1, t=1.787, P=0.075)。进一步比较人工肝治疗后1周PLT计数较基线的变化量，发现肝硬化组PLT下降幅度显著高于非肝硬化组(U=1986.5，P=0.026)，而在不同人工肝术式、治疗次数(3~5次)之间无显著差异(P值均＞0.05)。通过logisitic多因素分析发现，合并肝硬化(OR=3.097，95%CI：1.255~7.645，P=0.014)和基线PLT＞50×109/L(OR=0.019，95%CI：0.002~0.154，P＜0.001)是影响人工肝治疗后PLT＞50×109/L的独立危险因素。对基线PLT计数进行ROC曲线分析，发现基线PLT＞80.5×109/L是影响治疗后PLT＞50×109/L的最佳截断值，ROC曲线下面积为0.818。 结论 人工肝治疗对PLT的影响是暂时性的，但肝硬化患者的PLT生长能力弱于非肝硬化患者; 基线PLT＞80.5×109/L是降低人工肝治疗后出血风险的最佳界值。 |
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| AbstractList | 目的 探究乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者接受人工肝治疗后PLT计数的变化趋势和影响因素.方法 选取2018年1月—2021年11月在中山大学附属第三医院住院接受血浆置换治疗(n=102)和双重血浆分子吸附系统联合低剂量血浆置换(n=50)的152例HBV-ACLF患者,分析患者的临床资料和实验室指标.计量资料两组间比较采用独立样本t检验或Mann-Whitney U检验,计数资料两组间比较采用χ2检验;采用logisitic多因素分析影响人工肝治疗后PLT>50×109/L的危险因素,采用ROC曲线分析基线PLT计数对人工肝治疗后PLT>50×109/L的预测价值.结果 纳入患者以中年男性为主,70例(46.1％)患者在入院时合并肝硬化,114例(75.0％)患者接受3次人工肝治疗,基线PLT>50×109/L患者占比为88％.总体患者人工肝治疗后PLT计数较基线水平显著下降(79.5±47.7vs112.5±64.1,t=4.965,P<0.001),治疗后1周PLT计数升高至基线水平(97.2±50.7 vs 112.5±64.1,t=1.787,P=0.075).进一步比较人工肝治疗后1周PLT计数较基线的变化量,发现肝硬化组PLT下降幅度显著高于非肝硬化组(U=1986.5,P=0.026),而在不同人工肝术式、治疗次数(3～5次)之间无显著差异(P值均>0.05).通过logisitic多因素分析发现,合并肝硬化(OR=3.097,95％CI:1.255～7.645,P=0.014)和基线PLT>50×109/L(OR=0.019,95％CI:0.002～0.154,P<0.001)是影响人工肝治疗后PLT>50×109/L的独立危险因素.对基线PLT计数进行ROC曲线分析,发现基线PLT>80.5×109/L是影响治疗后PLT>50×109/L的最佳截断值,ROC曲线下面积为0.818.结论 人工肝治疗对PLT的影响是暂时性的,但肝硬化患者的PLT生长能力弱于非肝硬化患者;基线PLT>80.5×109/L是降低人工肝治疗后出血风险的最佳界值. 目的 探究乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者接受人工肝治疗后PLT计数的变化趋势和影响因素。 方法 选取2018年1月—2021年11月在中山大学附属第三医院住院接受血浆置换治疗(n=102)和双重血浆分子吸附系统联合低剂量血浆置换(n=50)的152例HBV-ACLF患者，分析患者的临床资料和实验室指标。计量资料两组间比较采用独立样本t检验或Mann-Whitney U检验，计数资料两组间比较采用χ2检验；采用logisitic多因素分析影响人工肝治疗后PLT＞50×109/L的危险因素, 采用ROC曲线分析基线PLT计数对人工肝治疗后PLT＞50×109/L的预测价值。 结果 纳入患者以中年男性为主，70例(46.1%)患者在入院时合并肝硬化，114例(75.0%)患者接受3次人工肝治疗，基线PLT＞50×109/L患者占比为88%。总体患者人工肝治疗后PLT计数较基线水平显著下降(79.5±47.7 vs 112.5±64.1, t=4.965, P＜0.001)，治疗后1周PLT计数升高至基线水平(97.2±50.7 vs 112.5±64.1, t=1.787, P=0.075)。进一步比较人工肝治疗后1周PLT计数较基线的变化量，发现肝硬化组PLT下降幅度显著高于非肝硬化组(U=1986.5，P=0.026)，而在不同人工肝术式、治疗次数(3~5次)之间无显著差异(P值均＞0.05)。通过logisitic多因素分析发现，合并肝硬化(OR=3.097，95%CI：1.255~7.645，P=0.014)和基线PLT＞50×109/L(OR=0.019，95%CI：0.002~0.154，P＜0.001)是影响人工肝治疗后PLT＞50×109/L的独立危险因素。对基线PLT计数进行ROC曲线分析，发现基线PLT＞80.5×109/L是影响治疗后PLT＞50×109/L的最佳截断值，ROC曲线下面积为0.818。 结论 人工肝治疗对PLT的影响是暂时性的，但肝硬化患者的PLT生长能力弱于非肝硬化患者; 基线PLT＞80.5×109/L是降低人工肝治疗后出血风险的最佳界值。 |
| Author | 朱姝 谢婵 陈苑莉 彭亮 王璐 许文雄 李学俊 |
| AuthorAffiliation | 中山大学附属第三医院感染科,广州510635 |
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| Author_FL | XU Wenxiong XIE Chan WANG Lu LI Xuejun ZHU Shu CHEN Yuanli PENG Liang |
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| Keywords | 肝功能衰竭 肝,人工 血小板 乙型肝炎病毒 |
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| Snippet | 目的 探究乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者接受人工肝治疗后PLT计数的变化趋势和影响因素。 方法 选取2018年1月—2021年11月在中山大学附属第三医院住院接受血浆置... 目的 探究乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者接受人工肝治疗后PLT计数的变化趋势和影响因素.方法 选取2018年1月—2021年11月在中山大学附属第三医院住院接受血浆置... |
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| SubjectTerms | Hepatitis B Liver cirrhosis Liver failure Regression analysis |
| Title | 人工肝治疗HBV相关慢加急性肝衰竭的血小板计数变化及其影响因素 |
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