酒精性肝硬化与乙型肝炎肝硬化、丙型肝炎肝硬化及自身免疫性肝硬化临床特点对比分析  

Comparative analysis of clinical features of alcoholic cirrhosis and cirrhosis due to hepatitis B, hepatitis C and autoimmune liver diseases

作　　者：单晓辉 郝书理 孙颖[3] 常彬霞[3] 滕光菊[3] 赵军[3] 张伟[3] 李保森[3] 邹正升[3] 

机构地区：[1]河北省永年县第一医院内科,057150 [2]解放军第三○二医院 [3]解放军第三○二医院非感染性肝病诊疗中心,北京100039

出　　处：《传染病信息》2013年第5期279-283,共5页Infectious Disease Information

基　　金：国家自然科学基金(81273249)

摘　　要：目的探讨酒精性肝硬化的临床特点及其与乙型肝炎（乙肝）肝硬化、丙型肝炎（丙肝）肝硬化和自身免疫性肝硬化临床特点的异同。方法总结和分析2002--2012年住我院的部分酒精性肝硬化患者（373例）的临床特点，并与同期住院的部分乙肝肝硬化患者（205例）、丙肝肝硬化患者（104例）和自身免疫性肝硬化患者（121例）的临床特点进行对比分析。结果酒精性肝硬化患者好发年龄段为40。59岁（68．36％），尤其以40。49岁发病率最高，达到43．43％。与其他3种病因所致的肝硬化患者相比，酒精性肝硬化患者男性占绝大多数（98．66％），差异有统计学意义（P〈O．01）。酒精性肝硬化患者的WBC、中性粒细胞绝对值、中性粒细胞绝对值／淋巴细胞绝对值比值和平均红细胞容积均明显高于其他3种病因所致的肝硬化患者，差异有统计学意义（P均〈O．01）。酒精性肝硬化患者的AST／ALT比值、TBIL和GGT／ALP比值均明显高于其他3种病因所致的肝硬化患者，差异有统计学意义（P均〈0．01）。结论酒精性肝硬化在我国的发病率不断升高，且与乙肝肝硬化、丙肝肝硬化和自身免疫性肝硬化相比有其独特的临床特点。应对酒精性肝硬化给予更多关注。Objective To investigate the clinical features of alcoholic cirrhosis and compare them with those of cirrhosis due to hepatitis B, hepatitis C and autoimmune liver diseases. Methods The clinical features of 373 patients with alcoholic cirrhosis ad- mitted to our hospital from 2002 to 2012 were analyzed, and compared with those of 205 patients with cirrhosis due to hepatitis B, 104 patients with cirrhosis due to hepatitis C and 121 patients with cirrhosis due to autoimmune liver diseases admitted in the same period. Results Alcoholic cirrhosis was most likely to occur in those aged 40-59 with the prevalence of 68.36%, especially in those aged 40-49 with tile highest prevalence of 43.43%. As compared with patients with cirrhosis due to the other three causes, males accounted for the largest proportion in patients with alcoholic cirrhosis （98.66%） （P〈0.01）. The levels of WBC, absolute neu- trophil count, neutrophil/lymphocyte ratio and MCV in patients with alcoholic cirrhosis were significantly higher than those in pa- tients with cirrhosis due to the other three causes （P〈0.01）. The ratio of AST/ALT, the level TBIL and the ratio of GGT/ALP in pa- tients with alcoholic cirrhosis were significantly higher than those in patients with cirrhosis due to the other three causes （P〈0.01）. Conclusions The incidence of alcoholic cirrhosis is rising in China, and the clinical features of alcoholic cirrhosis are unique as compared with cirrhosis due to hepatitis B, hepatitis C and autoimmune liver diseases. Alcoholic cirrhosis should be paid much more attention to.

关 键 词：肝硬化 酒精性 乙型肝炎 丙型肝炎 肝炎 自身免疫性 体征和症状 

分 类 号：R575.2[医药卫生—消化系统] R512.6[医药卫生—内科学]