986例肝硬化患者病因及临床特点分析  

Analysis of etiology and clinical characteristics in 986 patients with liver cirrhosis

作　　者：佟印妮 郑吉敏[1] 韩丹 江萍 王存凯 王玉珍[1] 白云[1] TONG Yin-ni;ZHENG Ji-min;HAN Dan;JIANG Ping;WANG Cun-kai;WANG Yu-zhen;BAI Yun(Department of Gastroenterology,Hebei General Hospital,Shijiazhuang 050051,China;Department of Dermatology,The Second Hospital of Heilongjiang Province,Haerbin 150010,China)

机构地区：[1]河北省人民医院消化科,石家庄050051 [2]黑龙江省第二医院皮肤科

出　　处：《肝脏》2022年第8期871-873,880,共4页Chinese Hepatology

基　　金：河北省2019年度医学科学研究课题(20190260)。

摘　　要：目的 分析近5年首次住院的肝硬化患者的病因分布及临床特点。方法 回顾性分析2016年1月至2020年12月于河北省人民医院首次确诊为肝硬化患者的临床资料,分析其病因分布情况及血浆D-二聚体水平在肝硬化的不同肝功能状态、有无腹水、是否合并自发性细菌性腹膜炎(SBP)中的差别。结果 986例肝硬化患者中乙型肝炎患者431例、酒精性肝病146例、隐源性肝病124例。血浆D-二聚体水平在肝功能Child-pughC级、B级、A级分别为2.71、1.36、0.41 mg/L,差异有统计学意义(P<0.05)。腹水组血浆D-二聚体的中位数为2.16 mg/L,无腹水组为0.49 mg/L(P<0.05);腹水SBP组D-二聚体的中位数为4.52 mg/L,腹水非SBP组1.98 mg/L(P<0.05)。结论 肝硬化的主要病因仍为乙型肝炎病毒感染。D-二聚体水平与肝功能损伤的严重程度密切相关,若D-二聚体水平明显升高应警惕腹水及SBP的发生。Objective To investigate the etiology and clinical characteristics of patients with liver cirrhosis with first hospitalization in recent 5 years.And to prevent,diagnose and treat liver cirrhosis based on etiology,as well as improve the survival rates.Methods The clinical data of patients with liver cirrhosis admitted to our hospital from January 2016 to December 2020 were retrospectively analyzed.The distribution of causes was recorded.The clinical data of plasma D-dimer levels in different liver functional status of cirrhosis,ascites,and spontaneous bacterial peritonitis(SBP)were collected.And the clinical significances were analyzed.Results Among the 986 patients with liver cirrhosis,431 complicated with hepatitis B virus(HBV)infection,146 complicated with alcoholic liver disease and 124 complicated with cryptogenic liver disease.There were significant differences in plasma D-dimer levels among different Child-pugh classification,(Child-pugh score C>B>A,P<0.05).The median of plasma D-dimer in ascites group and non-ascites group were 2.16 mg/L and 0.49 mg/L,respectively(P<0.05);The median of D-dimer in ascites SBP groupand non-ascites group were 4.52 mg/L and 1.98mg/L,respectively(P<0.05).Conclusion The main cause of liver cirrhosis is still HBV infection.The D-dimer level of patients with liver cirrhosis is closely related to the severity of liver function injury.If the level of D-dimer is significantly increased,ascites and SBP should be paid more attention to.

关 键 词：肝硬化 病因 D-二聚体 

分 类 号：R575.2[医药卫生—消化系统]