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目的研究影响肝硬化失代偿期并发肝肾综合征(HS)的几种可能的危险因素。方法2003年1月至2005年1月住院确诊为病毒性肝炎后肝硬化失代偿期患者86例。分析患者的3项生化指标:血钠、血CA50、血CA125及其随访资料。用COX比例风险模型进行单因素和多因素分析。结果(1)轻度、中度、重度低血钠症肝硬化患者的HS发生的中位时间分别为32d、24d、10d;(2)16例血CA50、血CA125升高的肝硬化患者的HS发生的中位时间为13d;(3)COX风险回归分析显示:低血钠症、血CA50、血CA125是肝硬化患者发生HS的独立的影响预后的重要因素。结论定时监测血钠、CA50、CA125是临床上评估肝硬化失代偿患者预后、指导治疗以及提前干预HS发生的一种简易而有效的方法。
Objective To study several possible risk factors of cirrhosis complicated with hepatorenal syndrome (HS). Methods From January 2003 to January 2005, 86 patients with decompensated liver cirrhosis after hospitalization were diagnosed as viral hepatitis. Analysis of three biochemical indicators of patients: sodium, blood CA50, blood CA125 and follow-up data. Univariate and multivariate analyzes using the COX proportional hazards model. Results (1) The median time of occurrence of HS in patients with mild, moderate and severe hyponatremia was 32d, 24d, 10d, respectively. (2) 16 patients with liver cirrhosis who had elevated serum levels of CA50 and CA125 The median time of occurrence of HS was 13 days. (3) The regression analysis of COX risk showed that hyponatremia, blood CA50 and blood CA125 were the independent prognostic factors of HS in cirrhotic patients. Conclusion Regular monitoring of serum sodium, CA50, CA125 is a simple and effective method to evaluate the prognosis of patients with decompensated liver cirrhosis, guiding treatment and early intervention of HS.