4132例酒精性肝病临床特征分析

Clinical characteristics of 4132 patients with alcoholic liver disease

目的 回顾性分析近10年收治的酒精性肝病（ALD）患者的临床特点.方法 对2003年至2012年收治的4 132例ALD患者的发病形式、年龄特点及每年收治的ALD比例进行比对分析.计量资料用方差分析;计数资料用x2检验. 结果 4 132例患者中男性占97.68％,女性占2.32％,年龄为18 ～ 95 （48.11±1o.58）岁,以40～60岁的人群分布最广泛.ALD占同期肝病患者的比例由2003年的2.00％上升至2012年的5.05％.在收治的所有患者中酒精性肝硬化比例最高（70.35％）,其次是酒精性肝炎（19.26％）、酒精性脂肪肝（6.29％）、酒精性慢加急性肝衰竭（4.09％）.≥60岁的ALD患者中,肝硬化占90.04％;40 ～ 60岁的ALD患者中肝硬化占73.81％,≤40岁的占50.42％（x 2=2921.48,P＜ 0.01）.比较ALD前后5年的分型变化,酒精性肝硬化和酒精性慢加急性肝衰竭的发生率均有增加,且酒精性慢加急性肝衰竭占每年本院收治的肝衰竭患者比例呈逐年上升趋势. 结论 ALD患者住院占比呈逐年上升趋势,主要分布于40～60岁的人群中,老年性ALD以肝硬化表现多见,酒精性肝硬化和慢加急性肝衰竭近年发病率有所增加.

Objective To study the clinical characteristics of patients with alcoholic liver disease （ALD）.Methods The records of the 302 Hospital of People＆#39;s Liberation Army （Beijing,China） were searched to identify patients diagnosed with liver disease for retrospective analysis of ALD.Measurement data was summarized as mean ± standard deviation and intergroup comparisons were made using ANOVA;count data was assessed using the chisquare test.Results Among the total 4132 ALD cases,97.68% were male and 2.32% were female;ages ranged from 18 to 95 years-old,with the average age being 48.11±10.58 years and the range of 40 to 60 years-old being the most frequently represented.Considering all patients with liver disease from 2003 to 2012,ALD cases increased over time （from 2.00% in 2003 to 5.05% in 2012）.The overall ALD cases were represented by alcoholic cirrhosis （70.35%）,alcoholic hepatitis （19.26%）,alcoholic fatty liver （6.29%）,and alcoholic liver failure （4.09%）.Among the ALD patients between 40 and 60 years of age,73.81% had cirrhosis,compared to 50.42% of ALD patients less than 40 years-old （P 〈 0.001）.Comparison of ALD cases in 5-year increments showed increasing trends in rates of alcoholic cirrhosis and alcoholic hepatic failure;moreover,there was an increasing annual trend in the percentage of alcoholic liver failure cases among the total cases of liver failure in our hospital.Conclusion From 2003 to 2012,our hospital admissions increased for patients with alcoholic liver disease,and the patients were primarily in the age range of 40-60 years-old.In general,incidences of alcoholic liver failure and cin-hosis increased in recent years,and cirrhosis has been common among the elderly patients with ALD.