Clinical Features Of 100 Patients With Acute Exacerbation Of Cirrhosis With Liver Function Decompensation

Objectives To investigate the reasonable diagnosis of patients with acute exacerbation of cirrhosis with liver function decompensation. Providing reference for clinical diagnosis and treatment.Methods Using retrospective analysis method to define 100 patients with acute exacerbation of cirrhosis with liver function decompensation as Liver cirrhosis group and 200 patients with acute on chronic liver failure(ACLF)(those patients are with chronic hepatitis and acute exacerbation of cirrhosis with liver functiondecompensation) as Liver failure group respectively which choose from January 2009 to April 2015 in the First Affiliated Hospital of Medical University of Anhui Department of infection.Follow the questionnaire to record the patient’s gender, age, the original cause liver disease, acute liver injury induced factors, the course of the disease, syndrome type, prognosis and outcome, registration of glutamic acid transaminase(ALT), aspartate aminotransferase(AST), total bilirubin(TBil), direct bilirubin(DBil), Plasma prothrombin activity(PTA), albumin, serum creatinine, serum sodium, white blood cell count and other indicators. Using SPSS16.0 software to analyze data and compare two groups of patients with liver disease etiology, acute aggravating cause liver damage, liver injury of acute aggravating illness duration, laboratory examination indexes, complications and clinical outcomes, etc.Results 1.There is no statistically significant difference in two groups of Gender, age, disease course of acute liver injury(P> 0.05). Hepatitis b virus(HBV) infection is the most important primary liver disease causes of two groups. Active hepatitis virus replication of two groups is the most important precipitating factor for acute liver injury. There is no statistical significance between the two groups for Primary liver disease etiology and aggravating cause liver damage(P> 0.05).2.Main laboratory indexes comparison: Serum albumin, ALT, AST, serum sodium levels of liver cirrhosis group is significantly lower than the liver failure group(P < 0.05);Serum creatinine level and WBC count are obviously higher than liver cirrhosis group(P < 0.05), the differences of TBil, DBil, serum globulin, PTA, AFP, and the HBV DNA laboratories loads of these indexes have no statistical significance(P > 0.05).3.Complications comparison: Hepatorenal syndrome, spontaneous peritonitis, the complication rate of hyponatremia in cirrhosis group are obviously higher than that of liver failure group(χ2 = 7.863, P = 0.005; χ2 = 6.022, P = 0.014; χ2 = 13.483, P = 0.000). Hepatic encephalopathy, gastrointestinal bleeding, infection, urinary tract, lungs, blood, and complication rate in two groups have no statistically significant difference(P > 0.05);There is statistically significant of the incidence of various complications at the same time(≥2)(P< 0.05), and liver cirrhosis group is higher than liver failure group.4.Clinical outcomes comparison: liver cirrhosis group has 10 cases improvement(10.00%), 81 cases stable or not cured(81.00%), and 9 cases died(9.00%).Liver failure group has 51 cases improvement(25.50%), 139 cases stable or not cured(69.50%), and 10 cases died(5.00%).The improvement rate in Liver cirrhosis group is significant higher than in liver failure group, the difference was statistically significant(χ2 = 9.888, P = 9.888), the mortality is similar between the two groups and has no statistical significance(P> 0.05).Conclusions 1.The etiology of liver disease, inducement, laboratory examination, complication occurrence of patients with acute exacerbation of cirrhosis with liver function decompensation has similar Clinical features with patients of ACLF.2.Compare to ACLF patients, patients with acute exacerbation of cirrhosis with liver function decompensation have more prominent clinical feature related to portal hypertension;3.Compare to ACLF patients, short-term prognosis is worse for patients with acute exacerbation of cirrhosis with liver function decompensation.4.To benefit Clinical interpersonal and improve diagnostic ability, suggest more appropriate diagnosis for patients with acute exacerbated liver function in patients with decompensated liver cirrhosis;5.This study uses retrospective analysis, which has the shortcoming of such as less sample size and difficult calculated onset time. Still need more evidence-based medicine support, and prospective study is necessary.