4173例肝炎后肝硬化患者的临床特征分析.docVIP

4173例肝炎后肝硬化患者的临床特征分析 赵义名，彭贵勇，房殿春，毛培军 （400038 重庆，第三军医大学西南医院全军消化病研究所） [摘要] 目的 了解我院肝炎后肝硬化患者的临床特征。方法 对2003年12月至2006年11月在本院消化科和感染科住院的4173例肝炎后肝硬化患者作回顾性研究，并对其中在2006年2-11月期间的住院患者进行终点随访。 结果　肝炎后肝硬化的年龄分布主要在30~60岁（83.1%），男女比例为4.15︰1；肝炎后肝硬化代偿期3121例（74.79%），失代偿期1052例（25.21%）。单纯乙型病毒性肝炎感染3623例(86.82%)，单纯丙型病毒性肝炎后肝硬化223例(5.34%)，乙肝或丙肝重叠其他肝炎病毒者274例（6.57%）。77.73%的肝炎肝硬化患者有食道胃底静脉曲张（GEV），47.48%的肝硬化患者有门脉高压性胃病（PHG），发生率与EV的严重程度相关。住院期间，713例上消化道出血者中，EV破裂出血者占274例（38.43%），PHG及消化性溃疡（PU）出血分别占319例（44.74%）和101例（14.17%）。582例肝炎肝硬化死亡患者中，HBsAg(+)患者573例（病死率51.90%），HBsAg(-)患者9例（病死率4.48%），RR=11.53；死因以上消化道出血为主(77.15%)。结论 乙肝引发的肝硬化是我国肝炎后肝硬化主要类型，上消化道出血是其最直接的死因，而PHG和GEV破裂出血是上消化道出血的主要原因。 [关键词] 肝硬化；病毒性肝炎；流行病学 [中图法分类号] R 575.2 [文献标志码] A Clinical features of post-hepatitic cirrhosis: report of 4 137 patients Zhao Yiming, Peng Guiyong, Fang Dianchun, Mao Peijun (Institute of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China) [Abstract] Objective To investigate the clinical features of post-hepatitic cirrhosis. Methods A total of 4 173 in-patients with post-hepatitic cirrhosis who admitted in our institute and Institute of Infectious Disease of our hospital from February to November 2006 were enrolled, Terminal study were carried out till February 2009. All patients were followed up and the data were retrospectively analyzed. Results The age of these patients was predominantly from 31 to 60, and their sex ratio was 4.15:1 for male to female. Among them, 3 121 patients (74.79%) were in compensation period, and 1052 (25.21%) were in decompensation period. And, 3 623 cases were determined as hepatitis B, accounting for 86.82%, 223 cases as hepatitis C, for 5.34%, and 274 cases suffered from hepatitis B or C superinfecting by other hepatitic viruses, for 6.5%. There were 77.73% patients suffering from gastroesophageal varices (GEV) and 47.48% of them having portal hypertensive gastropathy (PHG). The incidence was related with the degr