763例肝硬化患者的病因及临床特点分析

Etiology and clinical characteristics of patients with cirrhosis in 763 cases

[目的]探讨肝硬化患者的病因以及临床特点分析?为临床治疗提供参考。[方法]回顾性分析2008-01-2018-01期间住院的763例肝硬化患者的病因、并发症等临床特点。[结果](1)病因构成方面,乙型肝炎肝硬化482例(63. 17%).酒精性肝硬化96例(12.58%),乙型肝炎合并酒精性肝硬化62例(8. 13%),血吸虫性肝硬化26例(3.41%),自身免疫性肝炎21例(2. 75%).隐源性肝硬化19例(2.49%),其他15例(1.97%)。(2)以2013-01为时间节点?将所有患者划分为前后两段时间进行比较?乙型肝炎肝硬化患者人数由75.54%下降至53.89%,差异有统计学意义(x^2 =37. 598?P = 0. 000);酒精性肝硬化由7. 65%上升至16. 28%,差异有统计学意义(x^2 = 12. 680,P = 0. 000);乙型肝炎合并酒精性肝硬化由5. 50%上升至10.09%,差异有统计学意义(x^2=7. 670, P = 0. 006)o(3)肝硬化主要的并发症依次为上消化道出血(21.49%)、原发性肝癌(20. 18%))、自发性腹膜炎(12. 58%)、肝性脑病(6.95%)和肝肾综合征(3.67%)。乙型肝炎合并酒精性肝硬化患者上消化道出血、原发性肝癌的发病率与单纯乙肝肝硬化(x^2=18. 366,P = 0. 000;x^2=5. 761. P = 0. 016)和单纯酒精性肝硬化(x^2=5. 229, P = 0. 022;x^2=4. 143.P-0. 042)相比较?差异有统计学意义。[结论]肝硬化最主要病因仍以乙型肝炎为主?但酒精性肝硬化、乙型肝炎合并酒精性肝硬化的发病率明显增加,上消化道出血、原发性肝癌是肝硬化主要的并发症。

[Objective]To explore the etiology and clinical characteristics of patients with liver cirrhosis in 763 cases.[Methods] We retrospectively analyzed the etiology and complications of 763 patients with cirrhosis which hospitalized from January 2008 to January 2018.[Results](1 ) In terms of etiology, there were 482 cases(63. 17%)of hepatitis B,96 cases( 12. 58%)of alcoholic fatty liver,62 cases(& 13%)of hepatitis B with alcoholic fatty liver,26 cases(3. 41 %)of schistosomiasis cirrhosis,and 21 cases(2.75%)of autoimmune liver disease 19 cases(2. 49%) of cryptogenic cirrhosis, and 15 cases(1. 97%) of other cases.(2) Taking January 2013 as the time boarder, all patients were divided into two periods before and after the time boarder. The number of patients with hepatitis B cirrhosis decreased from 75? 54% to 53. 89 %, the difference was statistically significant(x^2= 37.598 .P = 0. 000). Alcoholic cirrhosis increased from7. 65% to 16. 28%,the difference was statistically significant(x^2= 12. 680,P = 0. 000);hepatitis B with alcoholic cirrhosis increased from 5.50% to 10.09 %, the difference was statistically significant ( x^2= 7. 670, P = 0. 006).( 3 ) The main complications of cirrhosis were upper gastrointestinal bleeding ( 21. 49%), primary liver cancerC 20.18 %), spontaneous peritonitis( 12.58 %), hepatic encephalopathy(6.95 %) and hepatorenal syndrome(3. 67%). The incidence of upper gastrointestinal bleeding and primary liver cancer in patients with hepatitis B complicated with alcoholic cirrhosis was significantly higher than that in patients with hepatitis B alone(= 18. 366 ,P = 0. 000;=5. 761 .P = 0. 016)and those with alcoholic cirrhosis alone(x^2 =5.229,P = 0. 022;x^2=4. 143,P = 0.042).[Conclusion] Hepatitis B is still the main cause of liver cirrhosis in this group, but the proportion of alcoholic liver cirrhosis and hepatitis B with alcoholic liver cirrhosis increased significantly. Upper gastrointestinal bleeding and primary liver cancer are the main complications of liver cirrhosis.