161例病理确诊酒精性肝病患者临床特点分析

Clinical analysis of 161 patients with alcoholic liver disease confirmed by pathology

目的分析经病理证实的酒精性肝病患者的临床特点。方法对解放军302医院收治的161例不明原因肝损害经临床及病理检查确诊酒精性肝病的患者进行临床及病理对比分析。结果 161例患者平均年龄(40.18±8.99)岁,男性158例(98.14%),病理诊断轻度肝炎128例(79.50%),中-重度肝炎33例(20.50%)。经过统计学分析,轻度酒精性肝病患者饮酒时间和累积饮酒量低于中-重度患者(U=2.571,P=0.006;U=2.818,P=0.005)。轻度酒精性肝病患者血清谷草转氨酶(Aspartate aminotransaminase,AST)、总胆红素(Total bilirubin,TBIL)、碱性磷酸酶(Alkaline phosphatase,ALP)、γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,GGT)水平低于中-重度患者(U=3.616,P=0.000;U=3.618,P=0.000;U=4.198,P=0.000;U=6.129,P=0.000),而谷丙转氨酶(Alanine aminotransferase,ALT)水平在两组间无统计学差异(U=1.843,P=0.065)。结论饮酒持续时间和累积饮酒量与酒精性肝损害密切相关,AST、TBIL、ALP、GGT增高的水平与病情严重程度相关,推测上述指标是酒精性肝病轻重程度的预测因素。

Objective To study the clinical characteristics of alcoholic liver disease （ALD） confirmed by pathology. Methods The clinical characteristics of patients diagnosed with ALD by pathology were analyzed. All the patients were hospitalized from January 1,2009 to December 31,2012 in our hospital. Results The alcohol consumption time of mild ALD was shorter and its cumulative alcohol consumption was lower than those of moderate and severe ALD （U = 2.571 ,P =0.006;U = 2.906,P = 0.004）,but there was no significant difference in the average daily alcohol consumption. （U = 1.512,P = 0.131）. The mild ALD＇s AST,TBIL, ALP,and GGT were lower than those of moderate and severe ALl） （U = 3.616,P = 0.000;U = 3.618,P = 0.000;U = 4.198,P = 0.000;U = 6.129,P = 0.000）,while there was no significant difference in ALT （U = 1.843,P = 0.065）. Conclusion The alcohol consumption time and cumulative alcohol consumption are significantly correlated with the severity of the disease. The serum AST, TBIL,ALP and GGT will be predictors of the severity of ALD.