2016~2019年住院肝功能异常患者病因分析

Etiological Analysis of Inpatients with Abnormal Liver Function during 2016~2019

目的对住院肝功能异常病例进行回顾性研究,分析疾病种类和特点,提高对肝功能异常疾病诊治水平。方法选择苏州市第九人民医院感染科2016-2019年住院肝功能异常患者为研究对象,回顾性分析其病因分布、主要病种年龄性别分布、病因变化趋势等。结果肝功能异常前5位病因依次是乙型肝炎、药物性肝损伤(DILI)、非酒精性脂肪性肝炎(NASH)、自身免疫性肝病、酒精性肝病。乙型肝炎以慢性乙型肝炎为主,发病率男性高于女性,好发人群为30~59岁中青年;30岁以下人群患者数量明显减少;2016-2019年乙型肝炎在历年肝功能异常病例所占比例无显著差异,但总体数量呈现逐年下降趋势;DILI好发于老年人,抗结核药、传统中药是导致DILI的主要原因;NASH男性多于女性,男性好发于20~29岁、30~39岁年龄段,女性好发于50~59岁、60~69岁年龄段;自身免疫性肝病好发于50~59岁女性。结论乙型肝炎在肝功能异常疾病分布中依然占重要地位,但数量呈现逐年下降趋势;DILI、NASH、自身免疫性肝病等非感染性肝病应引起高度重视与关注,采取相应的防治措施。

Objective To improve the diagnosis and treatment of liver dysfunction diseases,a retrospective study was carried out to analyze the types and characteristics of the diseases.Methods In-patients with abnormal liver function during 2016~2019 in the infection department of the Suzhou Ninth People’s Hospital were selected for the study,to analyze the distribution of etiology,the distribution of age and sex of the main diseases,the trend of etiological changes,etc.Results The first 5 causes of abnormal liver function were hepatitis B,drug-induced liver injury(DILI),non-alcoholic steatohepatitis(NASH),autoimmune liver disease and alcoholic liver disease.Hepatitis B is mainly chronic hepatitis B,the incidence was higher in men than in women,the high risk group is 30~59 years old.The number of patients under the age of 30 decreased significantly.From 2016 to 2019,there was no significant difference in the proportion of hepatitis B patients with abnormal liver function,but the overall number showed a downward trend year by year.DILI tends to occur in the elderly,anti-tuberculosis drugs,traditional Chinese medicine is the main cause of DILI.NASH is more common in men than in women.The male was mainly distributed in age groups 20~29 and 30~39,while the female was mainly distributed in age groups 50~59 and 60~69.Autoimmune liver disease is most common in women aged 50~59.Conclusion Hepatitis B still plays an important role in the distribution of liver dysfunction,but the number of hepatitis B is decreasing year by year.Non-infectious liver diseases such as DILI,NASH and autoimmune liver diseases should be paid more attention to and corresponding preventive measures should be taken.