海南地区黎、汉族人群患酒精性肝病的相关因素分析和临床疗效分析比较

Relevant factors and clinical treatment of aIcoholic liver disease between Li minority and Han people

目的:对黎族与汉族患酒精性肝病的相关因素进行比较和分析,为防治酒精性肝病提供参考依据。同时探讨黎、汉族人群酒精性肝病的临床治疗,并比较其疗效。方法:回顾性分析海南省昌江县人民医院和海南医学院附属医院2006年1月～2010年12月收治的108例酒精性肝病患者的临床资料,其中黎、汉族人各54例,其中酒精性肝硬化失代偿期患者共31例,其中黎族15例,汉族16例。对以上酒精性肝病患者的相关资料、因素和临床疗效进行比较、分析。结果:黎族患者日饮酒量200～800 g/d,平均日饮酒量为640.8 g/d,平均年龄(51.5±26.5)岁,平均饮酒年限为(23±7)年。汉族患者日饮酒量为50～1 500 g/d,平均日饮酒量为155.66 g/d,患者平均年龄(52.8±13.6)岁,平均饮酒年限为(26.4±13.5)年;黎族与汉族患酒精性肝病时GGT变化明显,两组间比较,黎族AST/ALT>2的患者较汉族多;黎族患者间断大量饮酒者较多,汉族患者持续少量饮酒者较多。比较黎族、汉族酒精性肝硬化失代偿期患者治疗前、后Child-Pugh评分变化差异均具有统计学意义(P<0.05)。两组治疗前、后Child-Pugh评分变化差值均数分别为5.40±1.85,3.40±1.53。A、B两组治疗前、后差异有统计学意义(P<0.01)。结论:黎族与汉族患者患酒精性肝病的相关因素有一定差异。在酒精性肝硬化失代偿期患者Child-Pugh评分变化黎族人群优于汉族人群,以此为据点,我们推测可能黎族人群体内存在某种保护机制,可以进一步从基因角度研究。

Objective： To explore relevant factors and clinical treatment of aIcoholic liver disease（ALD） between Li minority and Han people.Methods：Clinical data of 108 ALD patients including 54 Li and 54 Han patients,admitted from January 2006 to December 2010,were analyzed retrospectively.There were 31 cases with alcoholic cirrhosis,including 15 Li people and 16 Han people.Risk factors and therapeutically effect were compared.Results： Alcohol volume was 200-800 g per day in Li patients,with average volume as 640.8 g per day,average age as（51.5±26.5） y,and average drinking age as（23±7） years old.While alcohol volume of Han patients was 50-1 500 g per day,with average alcohol consumption as 155.66 g per day,average age as（52.8±13.6） years old ages and average drinking age as（26.4±13.5） years old.GGT had significant change in both groups.There were more Li patients with ASTALT2,and more Li patients with heavy drinking.There was significant difference in in the changes of Child-Pugh score before and after treatment in two groups（P0.05）（5.40±1.85,3.40±1.53,respectively）.Conclusions：There is difference in risk factors to some degrees between Li and Han people are different.Li people with alcoholic cirrhosis at decompensation stage have more satisfactory Child-Pugh score.From this view,it is speculated that Li people may have some protective mechanism and it needs further genetic study.