2001—2010年儿童非病毒性肝病谱分析  

Spectrum of pediatric non-viral liver disease during 2001-2010

作　　者：朱世殊[1] 董漪[1] 徐志强[1] 王丽旻[1] 陈大为[1] 甘雨[1] 王福川[1] 钟彦伟[1] 姜君[2] 张鸿飞[1] 

机构地区：[1]解放军第三〇二医院青少年肝病诊疗与研究中心,北京100039 [2]中国科学院北京基因组研究所,100005

出　　处：《传染病信息》2011年第5期279-281,285,共4页Infectious Disease Information

基　　金：中国肝炎防治基金会王宝恩肝纤维化研究基金(2008-0027)

摘　　要：目的探讨儿童非病毒性肝病占儿童肝病的比例、疾病谱及构成比,为儿童非病毒性肝病的防治提供依据。方法回顾性分析2001年1月—2010年12月在我院住院且进行肝脏活体组织病理检查的儿童非病毒性肝病703例,并与1983年6月—2000年12月病例作比较。结果①2001年1月—2010年12月儿童非病毒性肝病占同期儿童肝病的17.53%,比例逐年上升,尤其近2年达20%以上,与1983年6月—2000年12月儿童非病毒性肝病构成比相比,χ2=38.129,P=0.000。②2001年1月—2010年12月儿童非病毒性肝病疾病谱为66种,以肝脏代谢相关性疾病最多(46.23%)[其中单病种以肝豆状核变性最多(48.92%)],其次为胆道相关性疾病(11.66%)、药物性肝炎(10.53%)和非酒精性脂肪性肝病(7.54%)。③儿童非病毒性肝病重叠病毒性肝炎的比例为11.23%,不容忽视。④4.83%的儿童非病毒性肝病疑难病例通过基因等特殊检查得到确诊。结论①我国儿童非病毒性肝病病例近十年来快速增多,疾病谱迅速扩大,构成比与以往有明显的改变,且与病毒性肝炎重叠的病例不少见,值得注意。②诊断技术的进步和完善,促进了儿童非病毒性肝病疑难病例的确诊。Objective To investigate the proportion of pediatric non-viral liver disease to pediatric liver disease, liver disease spectrum and its proportion so as to provide evidence for the prevention and treatment of pediatric non-viral liver disease. Methods Clinical data of 703 pediatric patients with non-viral liver disease, who were admitted to our hospital from Jan. 2001 to Dec. 2010 and received liver biopsy, were analyzed retrospectively, and compared with that of the pediatric patients with non-viral liver disease admitted from Jun. 1983 to Dec. 2000. Results The proportion of pediatric non-viral liver disease to pediatric liver disease was 17.53% from Jan. 2001 to Dec. 2010, with an increasing tendency, especially during the past two years （an increase of over 20%）. The difference was significant between the proportion from Jan. 2001 to Dec. 2010 and that from Jun. 1983 and Dec. 2000 （X2=38.129, P=0.000）. The spectrum of pediatric non-viral liver disease covered 66 kinds of liver diseases in the enrolled individuals from Jan. 2001 to Dec. 2010. Among them, hepatic metabolism-related disease accounted for the largest proportion （46.23%）, among which hepatolenticular degeneration accounted for 48.92% of the single disease. Biliary-related disease accounted for 11.66%, drug-induced hepatitis 10.53% and non-alcoholic fatty liver disease 7.45%. It could not be ignored that the incidence of non-viral liver disease combined with viral hepatitis was 11.2%. The final diagnosis of 4.8% intractable cases of pediatric non-viral liver disease was confirmed by some special methods such as genetic technology, etc. Conclusions The number of the patients with pediatric non-viral liver disease has surprisingly increased in China over the past 10 years. The liver disease spectrum has expanded quickly and the proportion has changed significantly compared with the past. It can not be ignored that the number of pediatric patients with non-viral liver disease combined with viral hepatitis is not small. Furthermore, the dev

关 键 词：肝病 肝豆状核变性 病理学 儿童 

分 类 号：R256.4[医药卫生—中医内科学]