摘要
目的分析呼和浩特地区肝硬化失代偿期患者的病因结构及临床特征,为该病的临床诊疗提供帮助。方法收集2019年(1-12月)、2023年(1-12月)在内蒙古医科大学附属医院住院的肝硬化失代偿期患者共308例,比较两个时间段肝硬化失代偿期患者的病因构成,分析不同病因肝硬化失代偿期患者的并发症和临床特征。结果2019年和2023年肝硬化失代偿期患者主要病因为乙型肝炎、酒精性肝病、原发性胆汁性胆管炎、乙型肝炎+酒精性肝病、丙型肝炎,与2019年相比,2023年乙型肝炎和乙型肝炎+酒精性肝病所占比例降低(分别为32.76%vs.38.06%,2.30%vs.14.18%),而酒精性肝病、原发性胆汁性胆管炎所占比例增加(分别为34.48%vs.28.36%,24.71%vs.15.67%),差异有统计学意义(χ^(2)=23.762,P<0.001)。比较3种主要病因所致肝硬化失代偿期患者并发症和临床特征,乙型肝炎和酒精性肝病患者以男性居多(χ^(2)=113.283,P<0.001),平均年龄小于原发性胆汁性胆管炎者(χ^(2)=25.902,P<0.001),乙型肝炎患者有更高的肝癌发生率(χ^(2)=22.423,P<0.001),酒精性肝病患者肝性脑病占比更高(χ^(2)=10.745,P=0.005),且易合并高血压(χ^(2)=13.911,P=0.001)、糖尿病(χ^(2)=6.194,P=0.045),凝血功能异常明显,PT和INR更高(F=9.321、15.997,P均<0.001),PTA更低(F=14.961,P<0.001),差异均有统计学意义。结论肝硬化失代偿期患者病因结构发生变化,且不同病因所致者临床特征和并发症有其各自的规律和特点。
Objective To analyze the etiology and clinical characteristics of patients with decompensated liver cirrhosis in Hohhot to facilitate clinical diagnosis and treatment.Methods A total of 308 patients with decompensated cirrhosis hospitalized at the Affiliated Hospital of Inner Mongolia Medical University between January and December 2019 and January and December 2023 were prospectively enrolled.The etiology of patients with decompensated cirrhosis was compared between the two time periods,and the complications and clinical characteristics of patients with decompensated cirrhosis by etiology were analyzed.Results The main causes of decompensated cirrhosis in patients in 2019 and 2023 were hepatitis B,alcoholic liver disease,primary biliary cholangitis,hepatitis B+alcoholic liver disease,and hepatitis C.Compared with 2019,the proportions of hepatitis B and hepatitis B+alcoholic liver disease decreased in 2023(32.76%vs.38.06%,2.3%vs.14.18%,respectively),while the proportions of alcoholic liver disease and primary biliary cholangitis increased(34.48%vs.28.36%,24.71%vs.15.67%,respectively).The differences were statistically significant(χ^(2)=23.762,P<0.001).Comparison of complications and clinical characteristics among patients with decompensated cirrhosis due to the three main etiologies revealed that patients with hepatitis B and alcoholic liver disease were predominantly male(χ^(2)=113.283,P<0.001)and had a younger average age than those with primary biliary cholangitis(χ^(2)=25.902,P<0.001).Hepatitis B patients had a higher incidence of liver cancer(χ^(2)=22.423,P<0.001),while alcoholic liver disease patients had a higher incidence of hepatic encephalopathy(χ^(2)=10.745,P=0.005)and were more likely to have hypertension and diabetes(χ^(2)=13.911,P=0.001;χ^(2)=6.194,P=0.045).Coagulation abnormalities were also more pronounced,with higher PT and INR and lower PTA(F=9.321,15.997,14.961,P<0.001).Conclusion The etiology of patients with decompensated cirrhosis in this region had changed,and the clinical features and complications of patients with different etiologies had their own patterns and characteristics.
作者
赵海珍
鲍琢
马臻
ZHAO Haizhen;BAO Zhuo;MA Zhen(Department of Infection,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia 010020,China)
出处
《热带医学杂志》
2025年第10期1359-1362,1371,共5页
Journal of Tropical Medicine
基金
内蒙古自治区卫生健康科技计划项目(202202176)
内蒙古医科大学联合项目(YKD2023LH044)。
关键词
肝硬化失代偿期
乙型肝炎
酒精性肝病
Decompensated liver cirrhosis
Hepatitis B
Alcoholic liver disease
