肝硬化患者768例病因及临床特点分析

目的探讨云南省昆明地区肝硬化患者病因及临床特点。方法选择云南省第三人民医院消化内科2006年10月至2010年8月期间住院确诊的肝硬化患者768例，回顾性分析患者的临床资料和各项实验室检查结果。结果768例肝硬化患者中单纯乙型肝炎病毒感染所致肝硬化354例（46．1％），单纯饮酒所致肝硬化162例（21．1％），单纯丙型肝炎病毒感染所致肝硬化39例（5．1％），酒精合并肝炎病毒共同损伤所致肝硬化86例（11．2％），原发性胆汁性肝硬化45例（5．9％），血吸虫性肝硬化32例（4．2％），血色病等遗传及代谢性疾病所致肝硬化21例（2．7％），不明原因肝硬化29例（3．8％）。肝硬化并发症依次为上消化道出血（53．4％），肝性脑病（37．1％），继发感染（21．2％），原发性肝癌（16．4％）和肝肾综合征（5．9％）。结论云南省昆明地区的肝硬化病因以乙型肝炎病毒感染为主，其次为长期饮酒，单纯肝炎病毒感染所致肝硬化的临床表现以门脉系统高压为主，酒精中毒则以肝功能损伤为主，肝炎病毒感染与嗜酒重叠容易导致原发性肝癌的发生。

Objective To explore the etiology and clinical characteristics of liver cirrhosis patients in Kunming, Yunnan Province. Methods We retrospectively analyzed the clinical data and laboratory test results of 768 patients with liver cirrhosis admitted to our hospital from October 2006 to August 2010. Results Of the 768 patients, 354 cases（46. 1% ） had simple hepatitis B virus infection; 162 cases（21.1% ） had simple alcoholic cirrhosis; 39 cases（5.1% ） had simple hepatitis C virus infection; 86 cases（11.2% ） had co -injury caused by alcohol and hepatitis virus; the rest included 45（5.9%） cases with primary biliary cirrhosis and 29 （3.8%） cases with cryptogenic cirrhosis. All the signs and symptoms had no significant differences between viral infection patients and heavy drinker. Upper gastrointestinal bleeding （ 53.4% ）, hepatic encephalopathy （ 37.1% ）, secondary infection（21.2% ） and primary hepatic carcinoma（ 16.4% ） were main complications in liver cirrhosis. Conclusion Hepatitis B virus infection is still the main cause of liver cirrhosis in Kunming, Yunnan Province. 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.