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Suy giảm chức năng gan mạn tính cấp tính liên quan đến viêm gan B do tổn thương virus gan là có tiên lượng xấu hơn so với tổn thương không do virus
Tóm tắt
Các biểu hiện và tiên lượng của suy gan mạn tính cấp tính (ACLF) với các sự kiện thúc đẩy khác nhau có sự khác biệt đáng kể. Chúng tôi nhằm mục đích điều tra các đặc điểm và tiên lượng của bệnh nhân mắc ACLF liên quan đến viêm gan B do tổn thương virus gan (HVI). 452 bệnh nhân có chẩn đoán xác nhận về ACLF đã được sàng lọc tại ba trung tâm y tế ở Trung Quốc, và 203 bệnh nhân HBV-ACLF với các sự kiện cấp tính rõ ràng đã được phân tích hồi cứu. Theo các sự kiện thúc đẩy, bệnh nhân HBV-ACLF do tái hoạt động HBV và siêu nhiễm HAV được phân loại vào nhóm tổn thương virus gan và những bệnh nhân có nguyên nhân khác được phân thành nhóm tổn thương không do virus (NVI). Các đặc điểm lâm sàng, mô hình điểm dự đoán và tiên lượng của hai nhóm đã được so sánh. Tái hoạt động virus viêm gan B chiếm tỷ lệ lớn nhất (39,9%) trong tất cả các sự kiện thúc đẩy. Thời gian xấu đi của nhóm HVI kéo dài đáng kể hơn so với nhóm NVI (20 ngày so với 10 ngày, P < 0,001). So sánh tiên lượng giữa các nhóm cho thấy không có sự khác biệt đáng kể về tỷ lệ tử vong 28 ngày (20,9% so với 13,7%, P = 0,125), trong khi tỷ lệ tử vong 90 ngày và 1 năm ở nhóm HVI cao hơn ở nhóm NVI (36,3% so với 24,4%, P = 0,014; 39,5% so với 27,5%, P = 0,020, tương ứng). Trong nhóm HVI, mô hình nghiên cứu AARC không có lactic acid có giá trị dự đoán tốt hơn cho tỷ lệ tử vong 90 ngày (0,741). Tỷ lệ sống sót 90 ngày và 1 năm ở bệnh nhân HBV-ACLF do HVI thấp hơn so với NVI. Điểm AARC không có lactic acid là dự đoán tốt hơn cho tiên lượng ngắn và dài hạn ở bệnh nhân HBV-ACLF do HVI.
Từ khóa
#suy gan cấp tính #viêm gan B #tổn thương virus gan #tiên lượng #nghiên cứu hồi cứuTài liệu tham khảo
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