摘要
目的探讨肝炎后肝硬化和酒精性肝硬化患者的临床特征。方法选择2009年6月～2012年7月陕西省榆林市第一医院确诊的肝炎后肝硬化患者137例(肝炎后肝硬化组)及同期酒精性肝硬化患者82例(酒精性肝硬化组),对基本资料、临床症状和体征、实验室检查[γ-谷氨酰转移酶(GGT)、门冬氨酸氨基转移酶(AST)/丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、白球比(A/G)、总胆红素(TBIL)]及并发症发生率进行比较分析。结果①两组患者男性均占多数,酒精性肝硬化组男性比例(91.46%)高于肝炎后肝硬化组(64.23%),女性比例(8.54%)低于肝炎后肝硬化组(35.77%),差异均有统计学意义(均P<0.05);肝炎后肝硬化组患者平均年龄[(58.9±6.4)岁]较酒精性肝硬化组[(51.7±4.3)岁]大,差异有统计学意义(P<0.05);两组病程比较[(6.8±2.5)年比(5.9±2.7)年],差异无统计学意义(P>0.05)。②肝炎后肝硬化组患者肝掌(24.09%)、蜘蛛痣(28.47%)、男性乳房发育(1.46%)及肝大(6.57%)的发生率均低于酒精性肝硬化组(70.73%、80.49%、9.76%、51.22%),差异均有统计学意义(均P<0.05);而在脾大(59.85%比62.20%)、黄疸(13.87%比13.41%)和腹水(80.29%比76.83%)发生率方面,两组比较差异均无统计学意义(均P>0.05)。③肝炎后肝硬化组GGT[(63.8±10.2)U/L]、AST/ALT(1.01±0.22)及ALP[(119.6±25.3)U/L]均低于酒精性肝硬化组[(139.4±47.9)U/L、(1.98±0.53)、(215.7±46.5)U/L],差异均有统计学意义(均P<0.05);两组A/G及TBIL比较[(0.81±0.10)比(0.86±0.22)、(47.3±25.6)μmol/L比(49.4±27.3)μmol/L],差异均无统计学意义(均P>0.05)。④肝炎后肝硬化组患者肝肾综合征及原发性肝癌的发生率(8.03%、29.20%)均高于酒精性肝硬化组(3.66%、9.76%),差异均有统计学意义(均P<0.05);两组上消化道出血(37.23%比43.90%)及肝性脑病(20.44%比26.83%)的发病率差异无统计学意义(P>0.05)。结论根据肝炎后和酒精性肝硬化患者的临床特征,有针对性地采取预防和治疗措施,可以达到较好的治疗效果。
Objective To investigate the clinical characteristics of posthepatitic cirrhosis and alcoholic cirrhosis. Methods 137 patients with posthepatitic cirrhosis （posthepatitic cirrhosis group） and 82 patients with alcoholic cirrho- sis （alcoholic cirrhosis group） from June 2009 to July 2012 in the First Hospital of Yulin City were selected, basic da- ta, clinical symptoms and signs, laboratory examination （GGT, AST/ALT, ALP, A/G, TBIL） and complication rate were compared and analyzed. Results （1）Male patients were in majority in two groups, percentage of men in alcoholic cir- rhosis group （91.46%） was higher than that in posthepatitic cirrhosis group （64.23%）, percentage of women in alcoholic cirrhosis group （8.54%） was lower than that in posthepatitic cirrhosis group （35.77%）, the differences were statistically significant （P 〈 0.05）; average age in posthepatitic cirrhosis group [（58.9±6.4） years] was older than that in alcoholic cirrhosis group [（51.7±4.3） years], the difference was statistically significant （P 〈 0.05）; the difference of the course of disease in two groups [（6.8-±2.5） years vs （5.9±2.7） years] was not statistically significant （P 〉 0.05）. （2）The occurrence rate of liver palms （24.09%）, spider angioma （28.47%）, gynaecomastia （1.46%）, hepatomegaly （6.57%） in posthepatitic cirrhosis group were all lower than those in alcoholic cirrhosis group （70.73%, 80.49%, 9.76%, 51.22%）, the differ- ences were statistically significant （P 〈 0.05）; the differences of the occurrence rate of splenauxe （59.85% vs 62.20%）, jaundice （13.87% vs 13.41%） and ascites （80.29% vs 76.83%） in the two groups were not statistically significant （P 〉 0.05）.
出处
《中国医药导报》
CAS
2013年第21期99-101,共3页
China Medical Herald
关键词
肝炎后肝硬化
酒精性肝硬化
防治
Posthepatitic cirrhosis
Alcoholic cirrhosis
Prevention and cure
