Risk factors and clinical features on acute hepatic dysfunction induced by sepsis

Objective To study the risk factors and clinical features on acute hepatic dysfunction induced by sepsis.Methods One hundred and sixty-eight patients with sepsis were divided into 2 groups according to liver function:simple sepsis group (control group,142 cases) and acute hepatic dysfunction induced by sepsis group (observation group,26 cases).The biochemical indicators,plasma endothelin (ET)-1,sepsis-related organ failure assessment (SOFA) were compared between 2 groups.The risk factors of inducing acute hepatic dysfunction were analyzed.Results The incidence of acute hepatic dysfunction in 168 patients with sepsis was 15.5％ (26/168).The total bilirubin,direct bilirubin,creatinine,range of blood glucose variation,arterial blood lactic acid,plasma ET-1,SOFA,fatality rate in observation group were significantly higher than those in control group [(35.9 ±9.8) μμmol/L vs.(27.8 ±6.7) μmol/L,(17.7 ± 8.0) μ mol/L vs.(12.3 ± 5.9) μ mol/L,(219.6 ± 156.4) μ mol/L vs.(159.4 ± 125.3) μ mol/L,(7.6 ±4.9) mmol/L vs.(3.0 ± 1.6) mmol/L,(3.8 ± 1.3) mmol/L vs.(2.0 ± 1.2) mmol/L,(79.6 ±25.7)μg/L vs.(60.8 ± 12.6) μg/L,(8.8 ±2.6) scores vs.(5.7 ± 1.8) scores,38.5％ (10/26) vs.17.6％(25/142)],there were statistical differences (P ＜ 0.01 or ＜ 0.05).Multifactor Logistic regression analysis results showed that long-term drinking,cardiac insufficiency and hypotension were independent risk factors of acute hepatic dysfunction induced by sepsis.Conclusions The arterial blood lactic acid,plasma ET-1 and SOFA in patients with acute hepatic dysfunction induced by sepsis are higher.Long-term drinking,cardiac insufficiency and hypotension are the risk factors of acute hepatic dysfunction induced by sepsis. Key words: Sepsis ;  Liver diseases ;  Risk factors;  Endothelins