2006-2015年梧州地区两所医院肝衰竭患者病因、临床类型及其变迁的回顾性分析

Retrospective on Etiologies,Clinical Types and Etiology,Clinical Type and Changes Among Hepatic Failure Patients of Two Hospitals in Wuzhou District From 2006 to 2015

目的探讨2006-2015年广西梧州地区肝衰竭患者的病因、临床类型及其变迁情况。方法利用回顾性流行病学调查方法,对2006-01/2015-12在梧州市第三人民医院和广西桂东人民医院住院的241例肝衰竭患者开展调查,依据患者的性别、年龄、病因、诊断类型及出院转归等因素,利用卡方检验方法对其进行分组和分时段分析。结果在241例肝衰竭患者中,男性和女性比例为4.36∶1,年龄(41.53±13.69)岁,中年男性患者居多。不同类型肝衰竭患者性别、年龄和转归差异无统计学意义(P>0.05)。最常见的病因为嗜肝病毒感染(81.33%),常见的临床分型为慢加急性肝衰竭(69.29%)。近5年内,HBV感染所致的肝衰竭患者构成比明显比前5年下降(73.97%VS 62.50%,P<0.05),而药物性肝损害所致肝衰竭患者构成比明显比前5年上升(10.17%VS 5.48%,P<0.05);近5年内慢加急性肝衰竭构成比明显低于前5年(64.29%VS 80.82%,P<0.05)。在不同病因基础上继发感染、恶化,导致死亡发生率升高(P<0.01)。结论梧州地区肝衰竭的患者依然以嗜肝病毒感染为主,但药物肝损伤呈增加趋势,临床类型是以慢加急性肝衰竭为主,并发感染是患者恶化死亡的重要因素。

Objective To understand the pathogeny, types and their transitions of hepatic failure patients in Wuzhou City of Guangxi province from 2006 to 2015. Methods A retrospective study was conducted in the Hepatology Department of the Third People＇s Hospital of Wuzhou City and Guidong People＇s Hospital of Guangxi, about 241 hospitalization patients from January 2006 to December 2015 with liver failure were selected. We compared the differences among different stratifications such as gender, age, etiology,diagnosis type, outcome and the onset time. Chi - square test was used to divide the groups and time. Results Among 241 patients with liver failure, the ratio of male to female was 4.36： 1, the average age was 41.53 -＋ 13.69 years old. The elderly male patients were the multitude. The difference was no statistical significance with different cases of liver failure patient in gender, age and outcome. The most common cause of liver failure was the infection of hepadnaviridae （81.33%） , and the majority of clinical type was acute - on - chronic liver failure （69.29%）. In the most recent five years （2011 - 2015）, the proportion of patients with liver failure caused by HBV infection was significantly lower than the proportion in another five years （2006 -2010） （62.50% vs 73.97%, P 〈0.05）, and the proportion of patients with liver failure caused by drug - induced liver injury in most recent five years was significantly higher than the proportion of another five years （10. 17% vs 5.48% , P 〈0.05）. In the most recent five years, the composition proportion of acute - on - chronic liver failure was significantly lower than the proportion in another five years （64.29% vs 80. 82%, P 〈 0.05 ）. Secondary infection followed by different causes of liver failure have led to an increasing of liver function deterioration and caused more death （P 〈 0. 01 ）. Conclusion The most common cause of liver failure in Wuzhou was the infection of hepadnaviridae and was sustaining in the analysis period, but the drug - induced liver injury that led to the liver failure was increasing in recent years ; the majority of clinical type was acute - on - chronic liver failure; secondary infection followed by different causes of liver failure was an important factor that led to an increasing of the incidence of liver function deterioration and caused more deaths.