陕西地区肝衰竭病因构成及变迁特点分析

闫涛涛; 李娟; 付珊; 张柔; 任丹凤; 朱丽; 刘锦锋; 何英利; 赵英仁; 张欣欣

doi:10.3969/j.issn.1001-5256.2020.02.031

陕西地区肝衰竭病因构成及变迁特点分析

DOI: 10.3969/j.issn.1001-5256.2020.02.031

1. 西安交通大学第一附属医院感染科
2. 西安交通大学第一附属医院医疗信息管理办公室

基金项目:

国家“十三五”传染病重大专项(2017ZX10202202-002-006)；国家自然科学基金(81670537)；西安交通大学第一附属医院青年科学创新基金(2018QN-02)；

详细信息

中图分类号: R575.3
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出版历程
- 收稿日期: 2019-09-02
- 出版日期: 2020-02-20

Composition and changing trend of the etiologies of liver failure in Shaanxi Province,China

Department of Infectious Diseases,The First Affiliated Hospital of Xi'an Jiaotong University

Research funding:

摘要

摘要:
目的探讨陕西地区肝衰竭的病因构成及变迁特点。方法回顾性收集2008年1月-2017年12月在西安交通大学第一附属医院住院的来自陕西省的975例肝衰竭患者的临床资料并进行分析。根据肝衰竭临床类型,分为急性肝衰竭（ALF）（n=115）、亚急性肝衰竭（SALF）（n=165）及慢加急性肝衰竭（ACLF）（n=695） 3组。计量资料多组间比较采用单因素方差分析,两组间比较采用t检验;计数资料组间比较采用χ2检验。结果 ALF的首要病因为药物（25. 22%,29/115）,其次为HBV感染（21. 74%,25/115）; SALF的首要病因为HBV感染（35. 15%,58/165）,其次为药物（27. 27%,45/165）; ACLF的首要病因为HBV感染（87. 19%,606/695）,其次为酒精（3. 45%,24/695）。HBV感染、酒精性及药物性肝衰竭患者的年龄分布区间主要以20～60岁（595/689）、30～40岁（22/32）及30～70岁（67/89）为主。近5年HBV感染相关的肝衰竭比例较前5年显著下降（61. 52%vs81. 33%,χ...
- 肝功能衰竭 /
- 流行病学研究 /
- 陕西
Abstract:
Objective To investigate the composition and changing trend of the etiologies of liver failure in Shaanxi Province,China.Methods A retrospective analysis was performed for the clinical data of 975 patients with liver failure who were hospitalized in The First Affiliated Hospital of Xi'an Jiaotong University from January 2008 to December 2017. According to the clinical type of liver failure,the patients were divided into acute liver failure( ALF) group with 115 patients,subacute liver failure( SALF) group with 165 patients,and acute-on-chronic liver failure( ACLF) group with 695 patients. A one-way analysis of variance was used for comparison of continuous data between multiple groups,and the t-test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups. Results Drug was the primary cause of ALF( 25. 22%,29/115),followed by hepatitis B virus( HBV) infection( 21. 74%,25/115); HBV infection was the primary cause of SALF( 35. 15%,58/165),followed by drug( 27. 27%,45/165); HBV infection was the primary cause of ACLF( 87. 19%,606/695),followed by alcohol( 3. 45%,24/695). The main age distribution of patients with liver failure due to HBV infection,alcohol,and drug was 20-60 years( 595/689),30-40 years( 22/32),and30-70 years( 67/89),respectively. There was a significant reduction in the proportion of patients with HBV-related liver failure in the recent 5 years( 61. 52% vs 81. 33%,χ2= 45. 87,P < 0. 001),while there were significant increases in the proportion of patients with drug-induced liver failure( 13. 14% vs 4. 44%,χ2= 22. 10,P < 0. 001) and alcoholic liver failure( 4. 76% vs 1. 56%,χ2= 7. 85,P =0. 005). Further analysis showed that the age of onset of HBV-related liver failure in the recent 5 years was significantly higher than that in the first 5 years( 45. 3 ± 13. 0 vs 42. 5 ± 12. 9,t =-2. 567,P = 0. 011). Conclusion Management of chronic HBV infection is still an important link in the control of liver failure,and meanwhile,the prevention and treatment of drug-induced and alcoholic liver diseases should be strengthened. More attention should be paid to the treatment of elderly patients with liver failure.
- liver failure /
- epidemiologic studies /
- Shaanxi

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