肝硬化病因及临床特点分析178例

Etiology and clinical character of liver cirrhosis: an analysis of 178 cases

目的:探讨东北地区肝硬化患者病因及临床特点.方法:选择我院2007-01/2007-10住院确诊的肝硬化患者178例,回顾性分析患者的临床资料和实验室检查结果.结果:178例患者中单纯乙型肝炎病毒感染61例(34.3%),单纯丙型肝炎病毒感染11例(6.2%),乙型与丙型肝炎病毒重叠感染3例(1.7%),单纯饮酒所致肝硬化39例(21.9%),酒精合并肝炎病毒共同损伤所致肝硬化27例(15.2%),其他为原发性胆汁性肝硬化8例(4.5%),不明原因肝硬化29例(16.3%).肝炎病毒感染和酒精中毒所致肝硬化相比,除蜘蛛痣(χ2=4.503,P=0.034)外,其他症状和体征的发生率无显著性差异.肝硬化并发症为上消化道出血(42.0%)、原发性肝癌(28.7%)、继发感染(16.1%)和肝性脑病(11.2%).结论:东北地区的肝硬化病因仍然以乙型肝炎病毒感染为主.单纯病毒感染所致肝硬化的临床表现以门脉压力增高为主,酒精中毒则以肝功能损伤为主,肝炎病毒重叠感染及嗜酒与病毒感染并存容易导致肝癌的发生.

AIM： To investigate the etiology and clinical characteristics of liver cirrhosis in the Northeast of China. METHODS： We retrospectively analyzed the clinical data and laboratory test results of 178 patients with liver cirrhosis admitted to our hospital from January to October 2007. RESULTS： Of the 178 patients, 31 cases （34.3%） had simple hepatitis B virus infection; 11 cases （6.2%） had simple hepatitis C virus infection; 3 （1.7%） cases had overlapping infection of hepatitis B and C virus; 39 cases （21.9%） had simple alcoholic cirrhosis; 27 （15.2%） cases had co-injury caused by alcohol and hepatitis virus; the rest included 8 （4.5%） cases with primary biliary cirrhosis and 29 （16.3%） cases with cryptogenic cirrhosis. In addition to spider telangiectasia （Χ^2 = 4.503, P= 0.034）, other signs and symptoms had no significant differences between viral infection patients and heavy drinker. Upper gastrointestinal bleeding （42.0%）, primary hepatic carcinoma （28.7%）, secondary infection （16.1%） and hepatic encephalopathy were main complications in liver cirrhosis. CONCLUSION： Hepatitis B virus infection is still the main cause of liver cirrhosis in the Northeast of China, Portal hypertension often happens in simple viral infection, and liver function injury usually happens in simple alcoholism. Hepatocellular carcinoma occurs more frequently in the cases with overlapping infection of hepatitis virus and concurrent of alcohol- drinking and hepatitis viral infection.