军人肝病患者的临床与肝穿病理学特点研究

Clinical and liver biopsy pathological features in military patients with liver diseases: An analysis of 231 cases

目的探讨军人肝病患者的流行病学、血清学、临床表现及肝穿组织病理学特点。方法对231例住院军人肝穿患者的年龄、性别、入伍地、兵种、职别、临床表现、实验室检查及肝穿组织病理学特点进行调查分析。结果 231例住院军人患者中,男202例,女29例,发病年龄18～73(29.7±9.1)岁,其中18～25岁年龄段所占比例(48.1%)较高,55岁以上所占比例(7.4%)较低。病毒感染性肝病占68.0%,其中战友间传染发病占14.0%,非感染性肝病占32.0%;慢性肝损伤占64.9%,急性肝损伤占35.1%;士兵占47.2%,干部占38.1%,士官占8.7%,其他占6.1%。结论军人肝病患者平均发病年龄较低,以18～25岁为主;士兵所占比例高于干部;病毒性感染所致肝损伤、慢性肝损伤比例较高。对急性肝损伤应进行肝穿病理诊断并及时采取治疗措施,以防止病程慢性化。

Objective To explore epidemiological,serological and histopathological（by liver biopsy） features of liver diseases,and clinical manifestations in patients of the Chinese armed forces.Methods The clinical data of 231 cases of military patients with liver diseases in our hospital were retrospectively analyzed in terms of their age,gender,location of enlistment,services,official rank,clinical manifestation,and laboratory examination,and also pathological characteristics of liver biopsy.Results Among the 231 hospitalized military patients,202 were male and 29 were female.The age at onset of the disease ranged from 18 to 73 years（mean age 29.7±9.1）.Higher morbidity（48.1%） was found in the 18-25 year age bracket,while lower（only about 7.4%） in above 55-year-old age bracket.Virus infection accounted for 68.0% and non-virus infection accounted for 32.0%.About 64.9% of the patients suffered from chronic liver disease,while 35.1% from acute liver disease.In addition,the prevalence of liver disease was as high as 47.2% in the soldiers,slightly higher than that in the officers（about 38.1%）.Transmission of the disease between comrades in arms accounted approximately for 14.0%.Conclusions The mean age of onset of liver disease in military personnel is younger,ranging from 18 to 25 years old predominantly,and the incidence is gradually decreased along with the age.The prevalence of liver disease may be higher in soldiers than in officers.There is a higher percentage of virus infection-associated liver ailment and chronic liver ailment.For acute liver ailment,pathological diagnosis by liver biopsy should be made,and timely therapeutic measures should be taken to prevent transformation of acute to chronic stage.