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纸质出版:2010
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赵义名,彭贵勇,房殿春,毛培军.4 173例肝炎后肝硬化患者的临床特征分析[J].陆军军医大学学报(原第三军医大学学报),2010,32(24):2650-2653.
Zhao Yiming,Peng Guiyong,Fang Dianchun,Mao Peijun.Clinical features of post-hepatitic cirrhosis: report of 4 137 patients[J].J Amry Med Univ (J Third Mil Med Univ),2010,32(24):2650-2653.
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3 121例(74.79%),失代偿期1 052例(25.21%)。单纯乙型病毒性肝炎感染3 623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GEV的严重程度相关。住院期间,713例上消化道出血者中,GEV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%,573/1 104),HBsAg(-)患者9例(病死率4.48%,9/201),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。
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 1 052 (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 degree of severity. During hospitalized stay
274 patients (38.43%) of the 713 cases with upper gastrointestinal hemorrhage had esophageal varices (EV)
319 (44.74%) and 101 (14.17%) had PHG hemorrhage and peptic ulcer (PU) hemorrhage. Among the 1 104 HBsAg(+) patients
there were 573 patients dead
accounting for 51.90%
and among 201 HBsAg(-) patients
there were 9 patients dead (4.48%. RR=11.53). Their death was mainly caused by upper gastrointestinal hemorrhage (77.15%). Conclusion Cirrhosis due to hepatitis B is the dominant category of posthepatitic cirrhosis. Upper gastrointestinal hemorrhage is the main cause of death
which resulting from bleeding of PHG and EV.
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