酒精性肝硬化62例临床分析

Clinical analysis of alcoholic liver cirrhosis in 62 cases

目的分析探讨酒精性肝硬化(ALC)的临床特征。方法回顾性分析2009年9月～2012年4月本院收治的62例ALC患者临床资料。结果 62例中,男性58例,占93.6%;年龄35～77岁,平均54岁。所有患者均有严重的酒精滥用史,平均酒精摄入量100 g/d;平均饮酒年限25年,其中女性患者均少于20年。B超和CT检查均有不同程度的再生小结节形成。半数以上病例可见腹胀(85.3%)、营养不良(83.7%)、乏力(80.5%)、食道静脉曲张(78.3%)、脾大(75.7%)、肝区疼痛(68.1%)、腹水(54.5%)等症状;GGT、ALP、TBIL等指标对ALC的诊断价值不如AST/ALT,如果AST/ALT≥2,对ALC的诊断有较大意义。结论对ALC的诊断主要依靠酒精滥用史、肝脏功能检测,尤其是ALT/AST比值以及临床症状等综合分析。

Objective To analyze and investigate the clinical characteristics of alcoholic liver cirrhosis （ALC）. Methods Retrospective analysis was made in the clinical data of 62 patients with ALC in our hospital from September 2009 to April 2012. Results Among the 62 cases ,there were 58 males ones,which accounted for 93.6%. The average ages of all patients were 54 years old（ from 35 to 77 years old）. The patients all had the heavy alcohol consumption history, and their mean alcohol intaking was 100 g/d, and the average duration of addiction was 25 years （that for all females was less than 20 years）. Regenerative nodules of different degrees could be found by both type B ultrasound and CT scanning. Abdominal distension （ 85.3% ） , malnutrition （ 83.70/o ） , fatigue （ 80.5% ） , esophageal varix （78.3 % ） , splenomegaly （ 75.7 % ） , hepatalgia （ 68.1% ） , and ascites （ 54.5 % ） could be seen in more than half of all the cases. Compared with the value of indicators such as GGT, ALP, and TBIL in the diagnosis of ALC, that of AST/ALT was better. If AST/ALT ≥ 2,it had great value in the diagnosis of ALC. Conclusion The diagnosis of ALC mainly depends on the aggregate analysis including the history of alcohol abusing, the detection of liver function, especially the ratio of ALT/AST, and clinical symptoms, etc.