广西461例青少年肝硬化临床特点和流行病学分析

Epidemiological and clinical features of 461 patients with cirrhosis among young people from Guangxi province

目的探讨青少年肝硬化患者的临床特点和流行病学特征。方法收集广西地区1995年～2004年12所三甲医院的461例30岁以下肝硬化患者资料进行回顾性分析。结果80．04％患者为男性；2000年～2004年青少年肝硬化构成比较1994年～1999年明显降低；10年内平均住院费用、每日平均费用均有进行性增加趋势，平均住院日逐渐下降；64．86％（299／461）肝硬化病因是乙型肝炎，HBeAg阴性占81．96％（245／299）；24．08％病例发生上消化道出血，14．75％发生感染，3．69％发生肝性脑病，1．74％发生肝肾综合征，死亡组较非死亡组肝性脑病和肝。肾综合征发生率高。结论广西近10年青少年肝硬化所占比例有所下降，HBeAg阴性乙肝后肝硬化是广西青少年肝硬化主要类型，上消化道出血是最常见死因，青少年肝硬化死亡病例中肝性脑病和肝肾综合征发生率高。

Objective To investigate the epidemiological and clinical features of patients with cirrhosis among young people. Methods By retrospective analysis, 461 in-patients with cirrhosis who were less than 30 years of age collected from 12 hospitals in Guangxi province from 1995 to 2004 were studied. Results The 80.04% of patients with cirrhosis were male. The constitute ratio of young patients with cirrhosis from 2000 to 2004 was lower than that from 1995 to 1999. There was observed downward trend in average length of stay and upward trend in the average hospital stay cost. Two hundred and ninety-nine cases were determined as posthepatitis B cirrhosis, accounting for 64.86% of the patients. Two hundred and forty five cases were determined as HBeAg negative hepatitis B, accounting for 81.96% of 299 cases. The incidences of complication with cirrhosis that were upper gastrointestinal bleeding, infection, hepatic encephalopathy （HE） and hepatorenal syndrome （HRS） were 24.08% , 14.75% , 3.69% and 1.74% , respectively. The incidences of HE and HRS in group of death were higher than that in group of non-death. Conclusion The proportion of young patients with cirrhosis is declined in Guangxi province from 1995 to 2004. The most common type of posthepatitic cirrhosis is HBeAg negative cirrhosis. The most common cause of death is upper gastrointestinal bleeding. The incidences of HE and HRS are conspicuous in group of death patients with cirrhosis.