| Objective:to analyze the cause of cirrhosis and discuss the correlation between etiology and gender in patients with liver cirrhosis.Focus on studying the feasibility of nutritional risk screening in patients with liver cirrhosis by nutritional risk screening 2002(NRS2002).Method: Arranged the experimental steps and the experimental time seriously,made the information collection table.There were a total of 202 patients of liver cirrhosis from the Department of Gastroenterology and Infection in Affiliated Hospital of Southwestern Medical School from January to July in 2015.Recorded the serum albumin(ALB),prothrombin time(PT),total bilirubin(TBIL)on admission.Completed the Child-Pugh classification of liver function according to the patient’s clinical symptoms,signs,auxiliary examination.Finished the NRS2002 within 48 hours after admission.All patients were followed up until discharged from hospital.Recorded the information about the patients’ age,gender,discharge diagnosis,etiology,complications,NRS2002 score and so on into the information collection table.It was the trained physicians who had completed the NRS2002 score.The patients would suffer from nutritional risk if the score≥3,and vice versa they would not experience it if the score< 3.The Child-Pugh classification of was divided into 3 groups: grade A,grade B,grade C.According to the Child-Pugh classification the abnormal ALB was divided into 3 groups: slightly(≥ 35g/ L)or normal,moderately(28~34g/L),severely(< 28g/L);the abnormal PT was divided into 3 groups too: slightly(prolonged 1~3 seconds)or normal,moderately(4~6s),severely(>6s).According to the prevention and treatment of viral hepatitis,the abnormal TBIL was divided into 3 groups: slightly(< 44umol/L)or normal,moderately(44~110umol/L),severely(> 110umol/L).According to the 8th edition of internal medicine and clinical experience,the complications of cirrhosis were divided into 3 groups: mild complications or normal,moderate complications,severe complications.the “death” were divided into 2 groups until out of hospital:alive and dead.Established the database using Excel on the basis of information collection table.Analyzed the data using the statistical software SPSS17.0.Quantitative data was showed by mean,standard deviation,while the qualitative data was expressed by rate,constituent ratio and contrast ratio.Applied the logistic regression and Fisher’s exact probability test to analyze the correlation between the nutritional risk and Child-Pugh,ALB,PT,TBIL,complications and death.Results: 1.ordinary result: there were 202 patients with cirrhosis with an average age of(54.9 + 12.3)years,including 153 men and 49 women.The male average age was(53.7 + 11.4)years,and the female was(58.7+14.0)years,so the female average age was 5 years older than male.It was 138 cases who had encountered nutritional risk,including 106 men and 32 women.The male to female ratio of liver cirrhosis was 3.12:1.The male to female ratio of patients who occurred nutritional risk was 1.06,and there was no obvious difference.It was 93 cases suffered from hepatitis B virus.Related to the cause,the number of cases who had been hepatitis B virus was 65(42.5%),alcohol was 35(22.9%),hepatitis C virus was 1(0.7%),non alcohol fatty liver disease(NAFLD)was 1(0.7%),and autoimmune hepatitis(AILD)was 2(1.4%)of 153 male patients,while of 49 female patients hepatitis B virus was 28(57 0.1%),alcohol was 3(6.1%),chronic hepatitis C virus was 3(6.1%),NAFLD was 1(2.0%),AILD was 5(10.2%).The male to female ratio caused by hepatitis B virus was 2.32:1,while the alcohol was 11.67:1.The second cause of men was alcohol,while the women was AILD.The Child-Pugh classification: 45 cases with grade A,91 cases with grade B,66 cases with grade C.The ALB: the patients with slightly decreased or normal was 69,moderately was 73,severely was 60.The PT: mildly prolonged or normal was 127,moderately was 43,severely was 31.The TBIL: slightly was 141,moderately was 31,severely was 20.The number of cases with mild or no complication occurred was 71,moderately complications was 97,severely complications was 34.It was 8 cases who were dead.2.results of single factor analysis : the nutritional risk of patients with liver cirrhosis by NRS2002 was significantly associated with Child-Pugh,ALB,Pt and complications(p=0.001,0.000,0.026,0.000),and there was no statistical significance between nutritional risk and TBIL(p=0.119).The possibility of nutritional risk in patients with poor clinical outcome was 2.126~8.636 times as much as it with better clinical outcome.There was correlation between nutritional risk and death(P = 0.058).The mortality rate of patients with nutritional risk was 5.8%,and the mortality rate of patients without nutritional risk was 0.0%.3.results of multivariate factor analysis: the nutritional risk of patients with liver cirrhosis by NRS2002 was significantly associated with complications,ALB(p=0.000,0.001).The possibility of nutritional risk in patients with poor clinical outcome was as 3.338~8.513 times as much as it with better clinical outcome.Conclusion: 1.the hepatitis B cirrhosis accounts for the highest proportion in patients with liver cirrhosis.Men with hepatitis B cirrhosis are more than woman.The second cause of men is alcohol,while the women is AILD.2.the incidence of nutritional risk between male and female in patients with liver cirrhosis by NRS 2002 has no significant difference.3.the nutritional risk of patients with liver cirrhosis by NRS2002 was significantly associated with ALB,complications and death.The possibility of nutritional risk in patients with poor clinical outcome is several times as much as it with the better clinical outcome.4.It is feasible to screen the nutritional risk in patients with liver cirrhosis by NRS2002.5.The NRS2002 is applicable to almost all patients with liver cirrhosis,who have severe ascites can use the change of food-intake to determine the nutrition status. |
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