An Analysis Of The Influence Factors Of The Prognosis Of Patients With End-Stage Liver Disease Complicated With HRS

Objective To investigate the main risk factors and the quantitative relationship between the main risk factors with the survival time which influence the prognotice of end-stage liver disease with hepatorenal syndrome(HRS), for the analysis of the condition of HRS, prognostic and therapeutic method of choice to provide a comprehensive quantitative method.Methods The clinical data of 84 patients with end-stage liver disease with HRS from January 2006 and January 2015 in Shanxi Province people’s hospital and the second hospital of shanxi medical university was analysised by COX and Kaplan Meier survival analysis method, including the general situation, causes, causes, complications, fatality rate,the grade of liver function, liver and kidney function and the ending.Results 1.Single factor Kaplan- Meier survival analysis showed that: 1) with the increase of ascites level, thesurvival time was increased(P< 0.001);2) the higher the MELD score, the shorter the survival time(P< 0.001);3)the survival time of the grope of white blood cell(WBC) >10×109/L was significantly below the grope of WBC > 10×109/L(P < 0.001); the survival time of the grope of red blood cell(RBC) < 3.5×1012 / L was significantly lower than the RBC =(3.5~5.5) ×1012 / L group(P﹦0.02);thesurvival time of the grope ofthe content of hemoglobin(Hb) that decline was longer, the survival time ofthe grope of Hb(55~93) g/L was the longest(P﹦0.008); with the increase of TBIL, thesurvival time was descend(P﹦0.038); thesurvival time of the grope of Potassium(K) in the normal range was the longest(P﹦0.002); with the 24 h urine volume reduction, thesurvival time was significantly shortened(P< 0.001). 2.Multiariable COX model analysis showed that: five independent prognostic factors that closely related to the prognosis of this disease was selected: ascites and its degree(HR 0.581, 95% CI 0.413 to 0.581 P﹦0.002), the MELD score(HR 1.715, 95% CI 1.1703 to 1.715 P﹦0.006), the WBC(HR 1.985, 95% CI 1.129 to 1.985 P﹦0.017), 24 h urine(HR 1.752, 95% CI 1.197 to 1.752 P﹦0.004), PT(HR 1.039, 95% CI 1.010 to 1.039 P﹦0.007).Regression equation is: the prognostic index(PI) = 0.54 MELD score+ 0.685 WBC + 0.038 PT + 0.561 urine volume-0.543 the degree of ascites.Conclusions PI = 0.54 MELD score+ 0.685 WBC + 0.038 PT + 0.561 urine volume-0.543 the degree of ascites.MLED score, the WBC, PT, urine volume and ascites are the main factors that affect the prognosis, including the degree of ascites may be its protection factor, the rest of the four factors were its risk factors. It will be for the prognosis of patients with end-stage liver disease complicated with hepatorenal syndrome provide a good reference.Objective To investigate the clinical features of hepatorenal syndrome(HRS),and to guide the effective prevention and treatment of the disease.Methods The clinical data of 84 patients with HRS from Shanxi Province people’s hospital and the second hospital of shanxi medical university during January 2004 to October 2014 were retrospectively analyzed,and analyzed the general circumstances, causes, incentives, complications, liver function, kidney function, mortality and prognosis of HRS in patients with end-stage liver cirrhosis.Results(1)Thehistory of hepatitis of the patients with HRS was(14.0±11.2)years,the history of heavy drinking was(20.7±8.3)years and the history of decompensated liver cirrhosis was(4.6±6.9)years.(2)Massive refractory ascites, upper gastrointestinal bleeding, secondary infection, and electrolyte disturbances were the most common incentives of HRS, releasing a large number of aseitesis were more common in patients with type Ⅱ HRS(P <0.01).(3) The extent of damage of liver and kidney function in patients with HRS had some relevance with PTA, TBIL, ALB, BUN, Scr, Cys C, Hb, electrolytes, urine output and MAP,the dynamic variation of the above indicators may indicate remission or worse.(4)A total of 69 cases deathbed in 84 cases patients with HRS, the mortality rate was 82%, typeⅠHRS media survival period was 14.3 days, type Ⅱ HRS media survival period was 25.3 days.(5) On the basis of post-treatment terminal urine ≥1000ml / d, the survival rate was significantly increased with the changed value of MAP increased.Conclusions(1)The shortest history of decompensated liver cirrhosis of the patients with end-stage liver disease with HRS was 0.5 years,the clinicians need to pay close attention to the disease.(2)The mortality rate of the patients with HRS was high and the average survival period was short.(3) On the basis of post-treatment terminal urine ≥1000ml / d, the patients with the MAP increasing 6-30 mm Hg had a high survival rate.