酒精性肝硬化60例临床分析

CLINICAL ANALYSIS ON 60 CASES OF ALCOHOLIC CIRRHOSIS

目的:探讨酒精性肝硬化(AC)的发病情况、临床特点及预后.方法:回顾性分析60例AC患者临床资料,并对38例患者进行随访研究.结果:①AC占同期住院肝硬化(LC)患者总数的10.2%,均为男性,35岁～55岁71.7%;②血清AST/ALT≥2(48.3%)、GGT>50U/L(51.7%)、ALP>110U/L(41.7%)、MCV>95FL(16.7%),50%以上的患者肝脏体积增大;③上消化道出血35例(58.3%),感染33例(55%),原发性肝癌5例(8.3%),合并乙型肝炎病毒感染4例(6.7%);④治疗好转53例(88.3%),无效5例(8.3%),死亡2例(3.3%);⑤随访38例,24例存活(63.2%),再入院12例;⑥死亡原因以上消化道大出血8例(50%)及肝肾综合症4例(25%)为主.结论:AC在LC患者中占一定比例,中青年男性高发,临床表现无特异性,肝功能检测以AST、GGT、ALP升高为主,上消化道出血是AC常见的并发症和主要的死亡原因,戒酒后治疗效果较好.

Objective： To explore the morbidity, clinical characteristics and the prognosis of alcoholic cirrhosis （AC）. Methods： In a retrospective study, clinical data of 60 patients with AC were analyzed and 38 patients were followed up after discharge. Results： ①AC/LC was 10.2%. All patients with AC were male and the majority （71.7%） aged 35 to 55;②Among 60 AC, Sere AST/ALT≥2 （48.3%）, GGT〉 50U/L（51.7%）, ALP 〉 110U/L（41.7%）, MCV 〉 95FL（16.7%）, enlargement of livers in 50% patients; ③There were 35 patients complicated with upper gastrointestinal bleeding （58.3%）, 33 patients infected（55%）, primary hepatic carcinoma occurred in 5 patients （8.3 % ）, only 4 patients combined with HBV infection（6.3 % ） ; ④53 patients were cured（88.3 % ）, 5 were ineffective （8.3%）, and 2 died（3.3% ）; ⑤Among 38 patients who were followed up after discharge, 24 survived, 14 died, 12 were hospital zed again;⑥In all 16 patients who died, 8 were caused by massive hemorrhage of gastrointestinal tract （50%） and 4 were due to hepatorenal syndrome（25%）. Conclusion： It was remarkable that patients with AC were common. Young and middle - aged males were predominaody in AC. The symptoms and signs of AC were the same as that of LC. Rising AST,GGT and ALP were the main abnormalities of liver function. Upper gastrointestinal bleeding was the chief complication and supreme cause leading to death. Patients benefit from treatment and abstaining.