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Prognostic factors for chronic severe hepatitis and construction of a prognostic model

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Hepatobiliary & Pancreatic Diseases International 2008年第1期7卷 40-44页

作者： Li, Qian Yuan, Gui-Yu Tang, Ke-Cheng Liu, Guo-Wang Wang, Rui Cao, Wu-Kui Tianjin Infect Dis Specialty Hosp Intens Care Unit Tianjin 300193 Peoples R China

BACKGROUND: chronic severe hepatitis is a serious illness with a high mortality rate. Discussion of prognostic judgment criteria for chronic severe hepatitis is of great value in clinical guidance. This study was designed to investigate the clinical and laboratory indices affecting the prognosis of chronic severe hepatitis and construct a prognostic model. METHODS: The clinical and laboratory indices of 213 patients with chronic severe hepatitis within 24 hours after diagnosis were analyzed retrospectively. Death or survival was limited to within 3 months after diagnosis. RESULTS: The mortality of all patients was 47.42%. Compared with the survival group, the age, basis of hepatocirrhosis, infection, degree of hepatic encephalopathy (HE) and the levels of total bilirubin (TBil), total cholesterol (CHO), cholinesterase (CHE), blood urea nitrogen (BUN), blood creatinine (Cr), blood sodium ion (Na), peripheral blood leukocytes (WBC), alpha-fetoprotein (AFP), international normalized ratio (INR) of blood coagulation and prothrombin time (PT) were significantly different in the group who died, but the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB) and hemoglobin (HGB) were not different between the two groups. At the same time, a regression model, Logit (P)=1.573xAge+1.338xHE-1.608xCHO+0.011xCr-0.109xNa+1.298xINR+11.057, was constructed by logistic regression analysis and the prognostic value of the model was higher than that of the MELD score. CONCLUSIONS: Multivariate analysis excels univariate anlysis in the prognosis of chronic severe hepatitis, and the regression model is of significant value in the prognosis of this disease.

关键词： chronic severe hepatitis mortality prognostic model logistic regression analysis

Effect of medical ozone therapy on renal blood flow and renal function of patients with chronic severe hepatitis

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Chinese Medical Journal 2010年第18期123卷 2510-2513页

作者： GU Xi-bing YANG Xiao-juan ZHU Hong-ying XU Yue-qin LIU Xia-ying Department of Liver Diseases Wuxi Hospital for Infectious Diseases Wuxi Jiangsu 214005 China

Background Medical ozone therapy system was reported to have certain effects on the treatment of severe hepatitis, but its mechanism is not very clear. One of the causes of death of severe hepatitis is complication of renal damage or hepatorenal syndrome. The present study aimed to observe effects of medical ozone therapy system on plasma renin activity （PRA）, angiotensin II （All）, aldosterone （ALD）, renal blood flow and renal function of patients with chronic severe hepatitis and explore mechanisms of medical ozone therapy in the treatment of severe hepatitis. Methods Eighty-five cases with chronic severe hepatitis were randomly divided into ozone therapy group （43 cases） and control group （42 cases）. The patients in the ozone therapy group were treated with basic treatments plus ozone therapy system. Basic autohemotherapy was used. One hundred milliliter venous blood was drawn from each patient, and was mixed with 100 ml （35 pg/ml） medical ozone and then was returned the blood to the patient intravenously, once every other day for 20 days. Only the basic treatments were given to the control group. PRA, All, ALD, renal blood flow and damage to renal function of the two groups before treatment and 20 days after treatment were compared. Survival rates were also compared. Results Twenty days after the treatment, in ozone therapy group, PRA was （1.31±0.12） ng.m^-1.h^1, All （111.25±17.35） pg/ml, ALD （251.31±22.60） pg/ml, which decreased significantly compared with those before treatment （PRA （2.23±0.13） ***^-1.h^-1, All （155.18±19.13） pg/ml, ALD （405.31±29.88） pg/ml, t=4.67-14.23, P 〈0.01 ）, also lower than those of control group 20 days after the treatment （PRA （2.02±0.11） ***^-1.h^-1, All （162.21±15.32） pg/ml, ALD （401.20±35.02） pg/ml, t=4.97-15.61, P 〈0.01）; renal blood flow was （175.15±28.20） ml/min, which increased compared with that before the treatment （（125.68±21.25） ml/min） and was higher than that of control group 20 days after the treatment （（128.59±23.15

关键词： medical ozone chronic severe hepatitis renal blood flow

Assessment of prognosis and curative effect in patients with chronic severe hepatitis using the model for end-stage liver disease scores

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Chinese Medical Journal 2006年第2期119卷 148-150页

作者： WU Chi-hong TIAN Geng-shan XU Xiao-yuan YU Yan-yan LU Hai-ying Department of Infectious Disease Peking University First Hospital Beijing 100034 China

severe hepatitis is the most severe liver disease, with poor prognosis and high mortality. We explored the practical use of the model for end-stage liver disease （MELD） on clinical and the molecular adsorbents recirculating system （MARS） on chronic severe hepatitis to predict the short-term prognosis of patients with chronic severe hepatitis using the MELD score and the curative effect of MARS treatment.

关键词： chronic severe hepatitis end-stage liver disease molecular adsorbents recirculating system

A study on suicidal psychonosema and its treatment in patients with severe hepatitis B

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中国组织工程研究 2002年第7期6卷 1067-1067页

作者：潘伟业杨根究张国兴 Ankang Hospital of Hangzhou Public Safety Beurau HangzhouZhejiang 311113 China Sixth People's Hospital of Hangchou

Background:Suicide is an much severe public hygiene problem. It was reported that suicidal rate in our country was 22.2 per hundred thousand each year(1993).One third of which was caused by their own *** of severe hepatitis B suffer severe conditions of the disease with protracted course. It is easy for the patients to have severe psychonosema and suicide *** the abnormal mood of the patients could be found early, the suicide might be avoided,and the patient might get rehabilitation earlier. Objective:To analyze the suicidal causes of the patients of hepatitis B and to study the method of treatment or persuation. Unit:*** hepatitis,the Sixth People's Hospital of Hangzhou Subjects:9 suicidal cases by falling from high place at the Dept. of hepatitis B of the Sixth People's Hospital from 1991 to 2000 include 6 men and 3 women, with mean age of (36.7± 10.27) years(23～ 56 years) who were all diagnosed as chronic severe hepatitis with mean protracting course of (5.6± 4.2) years(2～ 11 years).The shortest inpatient time was 1 day,the longest was 228 days.7 of them were *** included 4 workers ,4 peasantsand individual *** educational levels included 5 graduates from high school,4 from junior middle *** all fell from the ward building for suicide. Intervention:The psychonosema were analysed by analyzing the patients'words,letters and their behavior before their *** therapy against these psychonosema were studied in order to avoid more suicide happen. Results:(1)Causes of suicides:One patient had symptoms of psychosis such as hallucination and delusional thinking disturbance.8 patients felt hopeless in curing the disease.4 cases had stress in family relationship. 3 cases could not endure body pain. 6 cases could not endure the heavy economic *** relationship stopped because of the disease in 1 case.(2) Manifestations before their suicides 6 patients had insomnia, emotional lability,anxiety,pessimism

关键词：重症肝病患者自杀心理障碍分析疏导方法 hepatitis B chronic severe hepatitis method of treatment middle school in order