不同原因肝硬化的人群特征与临床表现的对比研究

The comparative study of population characteristics and clinical performance differences in the livercirrhosis with different causes of disease

目的分析酒精性肝硬化（AC）与肝炎后肝硬化（VC）的发病人群特征及临床表现的差异。方法回顾性分析山东省滨州市人民医院收治的AC（70例）与VC（300例）患者的临床资料，比较两组患者性别、年龄、病程及肝硬化临床表现及天冬氨酸氨基转移酶／丙氨酸氨基转移酶（AST／ALT）、1，谷氨酰转肽酶（y-GT）、碱性磷酸酶（ALP）与总胆红素（TBil）的差异。结果AC组男性比例为91．43％（64／70），显著高于VC组64％（192／300）（X2=15．76，P=0．003）；AC组的平均年龄和病程分别为（50．13±12．35）岁和（2．09±0．67）年，显著低于VC组的（58．66±7．45）岁和（4．56±1．14）年（t=3．97，P=0．042；t=5．22，P=0．034）；两组患者间肝功能分级比较差异无统计学意义（P〉0．05）；肝功能退行性表现中AC组患者鼻出血（18．57％）、齿龈出血（27．14％）、肝掌（64．29％）、蜘蛛痣（45．71％）的比例显著高于VC组（6．33％、15．00％、47．00％、29．67％），其P值分别为0．017、0．036、0．025、0．016；门脉高压表现中AC组脾大（81．43％）、食管胃底静脉曲张（65．71％）的发病率显著低于VC组（90．33％、86．00％），其P值分别为0．037和0．011；肝硬化的实验室检查指标结果显示AC组患者的AST／ALT比值、1-GT、ALP分别为1．97±0．45、（152．33±23．41）U／L和（232．46±35．16）U／L，显著高于Vc组的1．00±0．22、（45．89±11．23）U／L及（102．23±21．78）U／L，其P值分别为0．035、0．011及0．007。结论AC与VC发病人群特征不同，临床表现和实验室指标亦存在着差异。

Objective To investigate the differences of the characteristic and syndrome of patients with alcoholic cirrhosis （AC） and viral cirrhosis （VC）. Methods Seventy patients with AC and 300 patients with VC in the Binzhou People＇s Hospital were selected as our subjects. The information including gender, age, disease history, clinical syndrome were collected. Meanwhile, the levels of Aspartate aminotransferase/alanine aminotransferase（ AST/ALT）, y-glutamyl transferase （ y-GT）, alkaline phosphatase （ALP） and total bilirubin （TBil） in serum were measured. Results The proportion of males in the AC group was 91.43% （64/70）, significantly higher than that of VC group（64% （192/300）, X2 = 15.76, P = 0. 003 ） ）. The age, disease periods in AC group were （50. 13 ±12. 35） years old and （2. 09 ±0. 67） years, lower than the VC group（ （58. 66 ＋ 7.45 ） years old, t = 3.97, P= 0. 042 ; （4. 56 ± 1.14 ） years, t = 5.22, P = 0. 034 ）. There was no significant difference regarding of liver function index （ P 〉 0. 05 ） . The rate of nasal carp （ 18.57% ）, gum bleeding （27.14%） ,liver palms（64. 29% ）, spider（45.71% ） in the AC group were significantly higher than the VC group （6. 33 %, 15. 00%, 47. 00%, 29. 67 % respectively., P = O. 017,0. 036,0. 025, O. 016 respectively）. The ratio of splenomegaly and esophageal varices were （81.43% ） and （65.71% ） in AC group, significantly lower than VC group （ 90. 33% , 86. 00% respectively, P = 0. 037,0. 011 respectively） . The cirrhosis laboratory parameters results Showed AST/ALT ratio （ 1.97 ± 0.45 ）, gamma-GT （ （ 152. 33 ± 23.41 ） U/L）, ALP indicators （ （232. 46 ±35. 16） U/L in AC group patients,which were significantly higher in the VC group（ 1.00 ± 0. 22, （45.89 ± 11.23 ） U/L and （ 102.23 ± 21.78 ） U/L, P = 0. 035,0. 011, 0. 007 respectively）. Conclusion There are difference in term of characteristic, manifestations and the testing laboratory indicators between alcoholic cirrhosis and viral cirrhosis.