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摘要：
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摘要：目的 分析肝功能衰竭患者主要临床指标与预后的关系。方法 选取2008年1月至2014年12月首
都医科大学附属北京地坛医院收治的96例肝功能衰竭患者为研究对象，住院期间或出院90 d内病死者
为病死组（36例），其余为存活组（60例），分析两组患者肝功能、肾功能、电解质、血糖（blood
glucose，Glu）、甘油三酯（triglyceride，TG）、胆固醇（total cholesterol，TC）、甲胎蛋白（alpha
feto protein，AFP）、凝血酶原活动度（prothrombin activity，PTA）等指标的差异，采用多因素Logistic
回归模型分析肝功能衰竭预后的独立危险因素。结果 病死组与存活组患者总胆红素（total bilirubin，
TBil）、白蛋白（albumin，ALB）、AFP、PTA、血钠（serum sodium，Na）、白细胞（leukocyte，
WBC）、血肌酐（serum creatinine，SCr）及Glu水平差异有统计学意义（P均＜ 0.05）。多因素
Logistic回归分析表明PTA和SCr是肝衰竭预后的独立影响因素（OR = 0.919，P = 0.006；OR = 5.594，
P ＜ 0.001）。ROC曲线分析表明PTA和SCr的曲线下面积（area under curve，AUC）分别为0.732、
0.828，相应Cut-off值分别为21%（敏感度64%，特异性72%）和128 μmol/L（敏感度69%，特异性
88%）。结论 PTA和SCr为肝功能衰竭患者预后的独立影响因素，PTA为保护因素，SCr为危险因素。
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Abstract: Objective To analyze the relationship between main clinical indexes and prognosis of patients
with liver failure. Methods Total of 96 cases with liver failure in Beijing Ditan Hospital, Capital Medical
University from January 2008 to December 2014 were selected, patients died in the hospital or discharged
from hospital within 90 days were in death group (36 cases), and the rest were in surviving group (60 cases).
The differences of liver function, renal function, electrolyte, blood glucose (Glu), triglyceride (TG), total
cholesterol (TC), alpha feto protein (AFP) and prothrombin activity (PTA) of patients in two groups were
compared. The independent risk factors for prognosis of liver failure were analyzed by multivariate Logistic
regression analysis. There were significant differences in total bilirubin (TBil), albumin (ALB), AFP, PTA,
serum sodium (Na), leukocyte (WBC), serum creatinine (SCr) and Glu levels between the two groups (P ＜
0.05). Results Logistic regression analysis showed that PTA (OR = 0.919, P = 0.006) and SCr (OR = 5.594,
P ＜ 0.001) were independent risk factors for the prognosis of liver failure. ROC curve showed that the area
under curve (AUC) of PTA and SCr were 0.732 and 0.828, respectively. The corresponding Cut-off values
were 21% (sensitivity 64%, specificity 72%) and 128 μmol/L (sensitivity 69%, specificity 88%), respectively.
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