摘要
目的:探讨肝炎病毒与酒精引起的肝硬化防治的不同侧重点.方法:选取2004-04/2009-05大连医科大学第一附属医院住院的952例肝硬化患者,按照病因不同分为肝炎后肝硬化(viral cirrhosis,VC)组、酒精性肝硬化(alcoholic cirrhosis,AC)组以及酒精与肝炎病毒混合性因素所致肝硬化(AC+VC)组,对比3组肝硬化患者性别、入院时年龄、病程、临床表现、肝功能分级、并发症,以及直接死因等差异.结果:在所有肝硬化中,VC所占比例最大(63.66%),AC居第2位.AC+VC组中最多见的是酒精+乙型肝炎患者,占该组肝硬化总数的2/3以上.3组肝硬化患者均以男性为主,AC组尤为突出(男∶女=48.5∶1).VC组与AC+VC组脾大的发生率明显高于AC组;3组肝硬化最常见的并发症都是上消化道出血.VC组原发性肝癌的发生率较AC组高,而AC组自发性腹膜炎的发生率明显高于VC组,二者差异显著(13.1%vs5.2%,P<0.01);无论是VC组还是AC组,最常见的死亡原因都是肝性脑病,然后依次是上消化道出血和原发性肝癌.AC+VC组最常见的死因是原发性肝癌.结论:对于肝炎后肝硬化和酒精性肝硬化患者,积极预防上消化道出血和肝性脑病的发生是防治病情加重的关键,对于后者还要加强预防肠道感染,而对于混合因素存在的肝硬化则要更加积极防治原发性肝癌的发生.
AIM：To compare the clinical characteristics,prophylaxis and treatment between viral and alcoholic cirrhosis.METHODS：The clinical data for 952 cirrhotic patients who were treated at the First Affiliated Hospital of Dalian Medical University form April 2004 to May 2009 were collected.These patients were divided into three groups：viral cirrhosis（VC） group,alcoholic cirrhosis（AC） group,and VC plus AC group.Sex,age,medical history,clinical manifestations,liver function,complications,and the main cause of death were compared among the three groups of patients.RESULTS：Of all cases,63.66% had VC.In the VC plus AC group,two-thirds of patients had alcoholic hepatitis and hepatitis B.Male patients were more commonly seen in the three groups,especially in the AC group（M：F = 48.5：1）.Compared to the AC group,the VC group and VC plus AC group had a high prevalence of splenomegaly.Upper gastrointestinal bleeding was the most common complication in all the groups.The prevalence of hepatocellular carcinoma in the VC group was higher than that in the AC group,and the prevalence of spontaneous bacterial peritonitis in the AC group was higher than that in the VC group（13.1% vs 5.2%,P〈0.01）.Hepatic encephalopathy was the common death cause in both the VC and AC groups,followed by upper gastrointestinal bleeding and hepatocellular carcinoma.The most common cause of death in the AC plus VC group was hepatocellular carcinoma.CONCLUSION：Prophylaxis and treatment of upper gastrointestinal bleeding and hepatic encephalopathy are important for patients with AC or VC.Prophylaxis of intestinal infection is important for AC patients.Prophylaxis of hepatocellular carcinoma is important for patients with both AC and VC.
出处
《世界华人消化杂志》
CAS
北大核心
2010年第31期3313-3319,共7页
World Chinese Journal of Digestology
基金
国家自然科学基金资助项目
No.30970886
大连市科技计划基金资助项目
No.2008E13SF193~~
关键词
肝炎后肝硬化
酒精性肝硬化
对比分析
防治
Viral cirrhosis
Alcoholic cirrhosis
Comparative analysis
Preventive treatment
