肝衰竭患者合并侵袭性真菌感染后患者转归的影响因素分析.docVIP

肝衰竭患者合并侵袭性真菌感染后患者转归的影响因素分析 作者：闫涛，王慧芬，苏海滨，林芳，许海苗，赵鸿，李雷，牟劲松，李晨 作者单位：北京，解放军302医院肝衰竭治疗研究中心，100039；闫涛，北京，解放军军医进修学院，100853 【摘要】 目的 了解肝衰竭并发侵袭性真菌感染患者预后的主要影响因素。方法 对1985年以来住院肝衰竭并发侵袭性真菌感染患者323例进行回顾性研究。按抗真菌感染治疗后的疗效，将患者分为有效组和失败组;按出院时患者主要诊断的综合疗效，将患者分为好转组和无效组。结果 抗真菌治疗有效组153例，失败组170例。出院时好转91例，无效232例。单因素分析，两组患者在主要诊断、抗真菌治疗效果、并发症数量、Child-Pugh分级和TBil、WBC水平上均有显著性差异(P均0.05)。多因素分析提示：并发症数量、抗真菌疗效和Child-Pugh分级为患者转归的有效预测因素;所得logistic回归方程的ROC曲线下面积为0.822。 结论 影响肝衰竭患者并发侵袭性真菌感染患者预后的主要因素有：并发症数量、抗真菌疗效和Child-Pugh分级。 【关键词】 肝衰竭 预后 真菌 感染 影响因素 　　Clinical study of factors in predicting prognosis of patients with hepatic failure after invasive fungal infectionsYAN Tao, WANG Hui-fen, SU Hai-bin,et al. The 13th department of 302 hospital of PLA, Beijing,100039 China 　　Abstract:　　Objective To study the factors that predict the prognosis of patients with liver failure followed by invasive fungal infections.Methods 323 hepatic failure patients with invasive fungal infections since 1985 were grouped by prognosis into two groups: improved group and ineffective group.Results When discharged, 91 patients were improved and 232 were ineffective. Significant difference were found in improved group and ineffective group at main diagnose, therapeutic effect of anti-fungal-infection, the number of liver-failure-related complications, Child-Pugh score, TBil level and the number of White blood cell(P0.05). In multivariate analysis, the number of liver-failure-related complications, therapeutic effect of anti-fungal-infection and Child-Pugh score are predicting factors for the prognosis of the patients. The AUC values generated by the ROC curves for the logistic regression equation was 0.822.Conclusion The main factors that predict the prognosis of hepatic failure patients with invasive fungal infections were complications and Child-Pugh score of patients, and anti-fungal therapy effect. 　　Keywords:hepatic failure；fungus；invasive infection；predicting factors 　　肝衰竭患者因免疫力低下极易并发各种感染，造成治疗上的困难及住院时间的