中国北方地区肝硬化病因及合并症的变迁

Changes of the aetiologies of cirrhosis and its complications in north China

目的阐明中国北方地区肝硬化病因及其合并症的变迁。方法回顾性分析2002年1月1日至2013年12月31日间首次住院的肝硬化病人人口学信息及其合并症,以2年为一时间段,分析中国北方地区肝硬化病因构成及合并症的变迁。结果12年间共12 948例肝硬化病人,其中男性8 937例(69.02%),女性4 011例(30.98%)。平均年龄(51.29±11.81)岁(7~93岁)。乙型肝炎病毒(hepatitis B virus,HBV)/丙型肝炎病毒(hepatitis C virus,HCV)相关及酒精性肝硬化以男性为主,而自身免疫性肝病所致肝硬化、药物性及非酒精脂肪性肝硬化以女性为主。住院肝硬化病人逐年增加,其病因构成变化:HBV相关肝硬化从86.72%降至78.65%(P<0.01),HCV相关肝硬化从8.07%升至19.27%(P<0.01)。酒精性、自身免疫性肝病所致肝硬化及不明原因肝硬化分别从7.68%至16.52%、2.65%至10.0%、0.72%至5.27%(P<0.01),非酒精性脂肪性肝硬化占3.76%(P<0.01)。腹水为最常见的合并症,占66.34%,单纯腹水、消化道出血构成比呈减少趋势,而2个以上合并症者呈增加趋势。结论住院肝硬化病人逐年增加,HCV相关性、酒精性、自身免疫性肝病所致肝硬化及非酒精性脂肪性肝硬化显著增加,HBV相关肝硬化减少。腹水、消化道出血仍为主要合并症,其构成比呈逐年减少趋势。

Objective To investigate the prevalence changes of aetiologies and complications of liver cirrhosis in northern China.Methods In this retrospective study, we identified cases of the demographic information and complications of patients with cirrhosis who were firstly hospitalized between December 31, 2013 to January 1, 2002.Two years were defined as a stage, to clarify the prevalence of the etiology of cirrhosis and complications in north China.Results Total 12 948 cirrhosis inpatients were included in this study during 12 years.Of them, male was accounted 69.02% and female 30.98%.The average age of all of the patients was （51.29±11.81） years （from7 to 93 year）.Hepatitis B virus/hepatitis C virus （HBV/HCV） and alcoholic liver cirrhosis were most male, and autoimmune, drug-induced and non-alcoholic related cirrhosis were predominantly female. The hospitalized patients with cirrhosis were gradually increased. HBV related cirrhosis had fallen from 86.72% to 78.65% （P〈0.01）, however, HCV related cirrhosis had increased from 8.07% to 19.27% （P〈0.01）. The alcoholic, autoimmune and cryptogenic cirrhosis were respectively increased from 7.68% to 16.52%, from 2.65% to 10.0% and from 0.72% to 5.27% （P〈0.01）. The non-alcoholic fatty liver cirrhosis accounted for 3.76%. Ascites is the most common complication accounted for 66.34%, simple ascites and gastrointestinal bleeding constituent ratio decreased, while more than 2 complications increased in cirrhostic patients. Conclusion Hospitalized cirrhotic patients are increased. A significant increased constituent ratio of HCV, alcoholic, autoimmune and nonalcoholic cirrhosis are observed. The constituent ratio of ascites, gastrointestinal bleeding remained a major complication, are decreased.