本文選題：肝病 + 疾病譜　； 參考：《皖南醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:分析皖南醫(yī)學(xué)院弋磯山醫(yī)院2002—2015年近14年肝病住院患者的疾病譜變遷并探討其疾病譜變遷的原因,為今后肝病住院患者的預(yù)防、治療及管理提供循證依據(jù)。方法:采用回顧性分析方法,收集2002年1月至2015年12月于弋磯山醫(yī)院住院治療的肝病患者的臨床資料,共8301例,其中病毒性肝炎6405例,運(yùn)用SPSS 19.0軟件及流行病學(xué)方法,對(duì)肝病住院患者各病種的例數(shù)及構(gòu)成比進(jìn)行分析和處理,并分析各病種年齡及性別分布情況。結(jié)果:2002-2015年間,該院住院治療的肝病患者中,最多見(jiàn)的是病毒性肝炎,其次為DILI、酒精性肝病、AILD、脂肪肝、血吸蟲性肝病以及其他肝病,其占肝病住院患者總例數(shù)的比值分別為77.16%、5.88%、3.02%、2.31%、1.30%、1.28%、9.05%)。此14年間該院肝病住院患者例數(shù)總體上呈逐年增加的趨勢(shì)。住院患者中病毒性肝炎的人數(shù)每年均排在其他肝病的首位,但其所占肝病住院患者比值呈持續(xù)性下降趨勢(shì),占比值均在70%以上;不同年度,藥物性肝病住院患者例數(shù)逐年增加,但其在肝病患者中的比值相對(duì)較穩(wěn)定,基本維持在5%左右;酒精性肝病的占比值自2006年起呈緩慢上升趨勢(shì),最高上升至5.65%;自身免疫性肝病的占比曲線整體上呈上升趨勢(shì),所占肝病住院患者的比值由0(2002年)上升至3.63%(2015年);脂肪肝的占比曲線波動(dòng)幅度較小,相對(duì)較為穩(wěn)定,各年度構(gòu)成比基本維持在1%左右。血吸蟲性肝病的占比曲線波動(dòng)較大,其占比值最低為0,最高為3.59%(2014年)。在病毒性肝炎患者中,以乙型肝炎為主,約占病毒性肝炎住院人數(shù)的86.63%,但其在病毒性肝炎住院患者中的占比值大體上呈下降趨勢(shì),丙型病毒性肝炎的占比值在2002-2011年間明顯增加,2012年起小幅度下降,最低下降至6.72%(2015年);甲型及戊型肝炎的占比曲線表現(xiàn)出下降的趨勢(shì)。在乙型病毒性肝炎中,慢性乙型病毒性肝炎仍然占主要部分,占比值為45.02%,值得注意的是,2002-2015年間,急性乙型病毒性肝炎在乙型病毒性肝炎住院患者中的占比值呈明顯下降趨勢(shì),所占比值由20.00%(2002年)下降至5.42%(2015年),乙肝肝硬化及肝癌(乙肝所引起的肝癌)的占比整體上呈上升趨勢(shì),慢性乙型病毒性肝炎在乙型病毒性肝炎住院患者中的占比值呈先上升后下降趨勢(shì),最低下降至30.17%(2015年),肝衰竭(HBV感染所致)的占比近年來(lái)亦呈小幅下降趨勢(shì)。各肝病住院患者,除AILD及藥物性肝病以女性多見(jiàn)外,其他各病種均以男性比較多見(jiàn),其中酒精性肝病男女之比為40.8:1,自身免疫性肝病男女之比為1:6.68。各病種住院患者基本上均以中年人多見(jiàn),病毒性肝炎主要集中在青中年人,其比例依次為33.47%、52.05%;酒精性肝病患者主要集中在中年人,占73.31%,其次為老年人、青年人,各占13.94%、12.75%。結(jié)論:2002-2015年間,該院肝病住院患者的疾病譜存在變遷,住院病毒性肝炎患者的人數(shù)雖然每年均在其他肝病的首位,但是其總體的構(gòu)成比正在下降;非感染性肝病中,藥物性肝病及自身免疫性肝病住院病例數(shù)逐年增加,酒精性肝病在肝病住院患者中的構(gòu)成比近幾年有所增加。值得注意的是,病毒性肝炎中,丙型肝炎的構(gòu)成比在2002-2011年顯著上升;乙型肝炎住院患者中,慢性乙型肝炎和急性乙型肝炎構(gòu)成比呈顯著下降趨勢(shì),乙型肝炎后肝硬化和乙肝相關(guān)肝細(xì)胞癌仍有較高的構(gòu)成比。自身免疫性肝病及藥物性肝病以中年女性多見(jiàn),其他各病種基本上以中年男性多見(jiàn)。
[Abstract]:Objective: to analyze the changes of the disease spectrum changes of the hospitalized patients with liver disease during the last 14 years from 2002 to 2015 in Wangnan Medical College, and to explore the causes of the changes in the disease spectrum, and provide evidence-based evidence for the prevention, treatment and management of the hospitalized patients with liver diseases in the future. Methods: the retrospective analysis method was used to collect the hospital from January 2002 to December 2015. The clinical data of the patients with liver diseases treated by hospital were 8301 cases, of which 6405 cases of viral hepatitis. The number and composition of the various diseases in the patients with liver disease were analyzed and treated with SPSS 19 software and epidemiological methods, and the age and sex distribution of various diseases were analyzed. The most common cases were viral hepatitis, followed by DILI, alcoholic liver disease, AILD, fatty liver, schistosomiasis liver disease and other liver diseases, which accounted for 77.16%, 5.88%, 3.02%, 2.31%, 1.30%, 1.28%, 9.05% in hospitalized patients with liver disease. The number of hospitalized patients in the hospital in the 14 years was increasing year by year. The number of viral hepatitis is ranked first in the other liver diseases every year, but the ratio of the hospitalized patients with liver disease is more than 70%. In different years, the number of hospitalized patients with drug-induced liver disease is increasing year by year, but the ratio of the patients in the liver disease is stable, and it is basically maintained at about 5%. The ratio of the occupation of autoimmune liver disease was up to 5.65% since 2006, and the proportion of the proportion of autoimmune liver disease was rising from 0 (2002) to 3.63% (2015), and the proportion of the proportion of fatty liver was relatively small and relatively stable, and the ratio of each year was basically maintained at 1% left. The ratio curve of the right. Schistosomiasis liver disease fluctuates greatly, the lowest ratio is 0, the highest is 3.59% (2014). In the patients with viral hepatitis, hepatitis B is the main factor, accounting for 86.63% of the number of hospitalized viral hepatitis patients, but the ratio of the hepatitis B in the patients with viral hepatitis is generally declining, and the ratio of the hepatitis C virus. There was a significant increase in 2002-2011 years, a small decrease in 2012, the lowest drop to 6.72% (2015), and a downward trend in the ratio curve of hepatitis A and HEV. In hepatitis B, chronic hepatitis B is still the main part of hepatitis B, accounting for 45.02%. It is worth noting that, during 2002-2015 years, acute B virus The ratio of hepatitis B in patients with hepatitis B was obviously decreased, the ratio of HBV decreased from 20% (2002) to 5.42% (2015). The proportion of HBV liver cirrhosis and liver cancer (HB liver cancer) was on the whole, and the ratio of chronic hepatitis B in patients with hepatitis B was in the ratio. The trend was first and then decreased to 30.17% (2015). The proportion of liver failure (HBV infection) was also decreasing in recent years. All the patients with liver disease, except for AILD and drug liver disease, were more common in men, and the ratio of male and female to alcoholic liver disease was 40.8:1 and autoimmune liver disease. The ratio of male and female to 1:6.68. in all patients was mostly seen in middle-aged people. Viral hepatitis was mainly concentrated in middle-aged and middle-aged people, the proportion in turn was 33.47%, 52.05%. Alcoholic liver disease was mainly concentrated in middle-aged people, accounting for 73.31%. The second was old people, young people, each accounted for 13.94%, 12.75%. conclusion: the hospital liver disease was hospitalized in 2002-2015 years. The number of patients with viral hepatitis is in the first place in other liver diseases every year, but the overall composition ratio is decreasing; in non infectious liver diseases, the number of hospitalized cases of drug-induced liver disease and autoimmune liver disease is increasing year by year, and the composition of alcoholic hepatopathy in the hospitalized patients with liver disease has been compared in recent years. Increase. It is worth noting that in viral hepatitis, the composition of hepatitis C is significantly increased in 2002-2011 years; in patients with hepatitis B, the proportion of chronic hepatitis B and acute hepatitis B is significantly decreased, and there is still a higher constituent ratio in HBV and HBV related hepatocellular carcinoma. Physical liver disease is more common among middle-aged women, and most of the other diseases are middle-aged men.

【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R575

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本文編號(hào)：1820055