Analyze The Hepatitis B Virus Related Acute-on-chronic Liver Failure On Aspects Of Causes And Clinical Prognosis

Objective Discuss the risk factors of hepatitis B virus related acute-on-chronic liver failure,and analyze the influence of clinical factors on prognosis.Methods Retrospectively analyzed 117 cases of patients with HBV-ACLF in Infectious Diseases Department of General Hospital of Ningxia Medical University from January 2006 to December 2015.Collect general information,including gender,age,nation,predisposing factors,complication,whether treated with antiretroviral,and laboratory indicator(total bilirubin,blood urea nitrogen,serum creatinine,white blood cell,platelet,Na+,K+,Prothrombin activity,Alpha fetoprotein,Hepatitis B virus DNA level,hepatitis B surface antigen,hepatitis B e antigen,Abdominal ultrasound and computed tomography,ect.)Results(1)The total number of patients is 117,included 101 male an d 16 female,80 cases of Han and 29 cases of Hui.All of those patients,50 people improved,67 people dead/deteriorated.(2)The pathogenesis of HBV-ACLF inducement caused by self-deactiv ated or irregular use of antiviral drugs were increased.there was no statisti cally significant difference in constituent ratio between the better group and the deterioration /death group(p>0.05).(3)The deterioration /death group age is above the better group,and the improvement rate of age less 50 group was obviously higher than that of above 50 years old group,The difference was statistically significant(p<0.05).(4)Better group of AFP levels was obviously higher than deterioration /death group,The difference was statistically significant(p<0.05).the higher AFP level,the better the prognosis;(5)there was no statistically significant difference between the Chronic hepatitis group and the Cirrhosis of the liver group(p>0.05).(6)With disease progression,the recovery is falling,and the difference between groups was statistically significant(p<0.05).(7)HBV DNA level,HBe Ag positive or not have no influence on prognosis,there was no statistically significant difference between the better group and the deterioration /death group(p>0.05).(8)The effect of Internal medicine + antiviral treatment is significantly better than pure medical treatment,The difference was statistically significant(p<0.05).(9)The incidence of hepatic encephalopathy,hepatorenal syndrome,electrolyte disorder in Deterioration /death group,is significantly higher than improving group,the difference has statistical significance.The incidence of complications in deterioration /death group,especially those with three or more complications,is significantly higher than the better group(p>0.05).(10)Logistic regression analyzed the effect factors of the prognosis of patients with HBV-ACLF,We found that clinical stage and age are risk factors affecting the prognosis of disease.Early clinical stage group after treatment is 13.323 times higher than the late,the improvement rate of age less than 50 after treatment is 4.41 times higher than the aged over 50 people.Conclusion(1)Patients with HBV-ACLF caused by a drug withdrawal or irregular medication were increased;(2)The greater the age,the later clinical stage and the more complications,The worse prognosis of patients with HBV-ACLF;.(3)The higher AFP level and the antiviral treatment,The better the prognosis of patients with HBV-ACLF.