青海地區(qū)酒精性肝病201例臨床特點分析
發(fā)布時間：2018-10-20 19:40
【摘要】：目的對青海地區(qū)酒精性肝病（alcoholic liver disease，ALD）患者的臨床病歷資料進行分析，探討酒精性肝病的發(fā)病情況、總結(jié)其臨床特點及預(yù)后，以提高對ALD的認識，為早期診斷、早期治療ALD提供臨床依據(jù)。 方法對2008年1月至2013年11月于青海大學(xué)附屬醫(yī)院住院確診的201例ALD患者的臨床病歷資料進行回顧性分析，分析酒精性脂肪肝(alcoholic fatty liver，AFL)、酒精性肝炎(alcoholic hepatitis，AH)和酒精性肝硬化（alcoholic cirrhosis，AC)三組的年齡、職業(yè)、肥胖、飲酒量、飲酒時間與ALD的關(guān)系，進一步分析飲酒量、飲酒時間對肝硬化Child-Pugh分級的影響；比較三組間生化和影像學(xué)指標(biāo)的差異；分析部分ALD患者多次住院及死亡原因；分析Maddrey函數(shù)與ALD的不同病情和預(yù)后的關(guān)系。 結(jié)果AFL組患病年齡主要在31-40歲之間，AH和AC組患病年齡主要在41-50歲之間；工人和干部飲酒者較多，AFL組以肥胖患者為主。ALD的發(fā)病與飲酒量、飲酒時間有關(guān)。肝硬化Child-Pugh分級A、B、C三級的飲酒量組間比較差異有統(tǒng)計學(xué)意義（p＜0.05），而飲酒時間組間比較差異無統(tǒng)計學(xué)意義（p＞0.05）。肝功能檢測AST/ALT、A/G、TCH、TG、HDL組間比較差異有統(tǒng)計學(xué)意義（p＜0.05），隨著肝損害的加重，A/G、TCH、TG、HDL呈逐漸下降，，而AST/ALT則呈逐漸升高。門靜脈血流速度組間比較差異有統(tǒng)計學(xué)意義（p＜0.05），且隨肝損害加重而減慢；肝/脾CT值組間比較無統(tǒng)計學(xué)意義（p＞0.05）。ALD患者多次住院和死亡的主要原因是肝硬化的晚期并發(fā)癥，上消化道出血居首位。不同病情和預(yù)后患者的Maddrey函數(shù)評分差異均有統(tǒng)計學(xué)意義（p＜0.05）。 結(jié)論青海地區(qū)男性是ALD的主要患病人群，臨床特點無特異性；ALD的病情和預(yù)后與長期大量飲酒有關(guān)；Maddrey函數(shù)與病情輕重及預(yù)后關(guān)系密切；ALD患者多次住院和死亡的首要原因為上消化道出血；對飲酒者應(yīng)定期檢測相關(guān)血生化及影像學(xué)指標(biāo)；從而爭取早診斷、早治療、改善預(yù)后。
[Abstract]:Objective to analyze the clinical records of patients with alcoholic liver disease (alcoholic liver disease,ALD) in Qinghai area, to explore the incidence of alcoholic liver disease, and to summarize its clinical characteristics and prognosis, so as to improve the understanding of ALD and to make early diagnosis. Early treatment of ALD provides clinical basis. Methods from January 2008 to November 2013, the clinical records of 201 patients with ALD diagnosed in the affiliated Hospital of Qinghai University were retrospectively analyzed. To analyze the relationship among age, occupation, obesity, alcohol consumption, drinking time and ALD in the three groups of alcoholic fatty liver (alcoholic fatty liver,AFL), alcoholic hepatitis (alcoholic hepatitis,AH) and alcoholic cirrhosis (alcoholic cirrhosis,AC). To compare the differences of biochemical and imaging indexes among the three groups, to analyze the causes of hospitalization and death of some ALD patients, and to analyze the relationship between Maddrey function and the different condition and prognosis of ALD. Results the prevalence age of AFL was mainly between 31 and 40 years old, that of AH and AC group was between 41 and 50 years old, that of workers and cadres drinking alcohol was more, and that of AFL group was mainly obesity. The incidence of ALD was related to the amount of alcohol consumed and the time of drinking. There was a significant difference in alcohol consumption between the three groups (p < 0. 05), but there was no significant difference between the drinking time groups (p > 0. 05). There was significant difference in liver function test between AST/ALT,A/G,TCH,TG,HDL groups (p < 0. 05). With the exacerbation of liver damage, the level of AST/ALT decreased gradually, while AST/ALT increased gradually. There was significant difference in portal vein blood flow velocity between the two groups (p < 0. 05), and it slowed down with the exacerbation of liver damage, but there was no significant difference between the two groups (p > 0. 05). ALD). The main cause of hospitalization and death in patients with liver cirrhosis was the late complications of cirrhosis, and there was no significant difference between the two groups (p > 0. 05). Upper gastrointestinal bleeding was the first. The scores of Maddrey function in patients with different conditions and prognosis were significantly different (p < 0. 05). Conclusion in Qinghai, men are the main patients with ALD, the clinical characteristics are not specific, the condition and prognosis of ALD are related to long-term heavy drinking, the Maddrey function is closely related to the severity of the disease and prognosis. The primary cause of hospitalization and death in patients with ALD is upper gastrointestinal hemorrhage, and the related biochemical and imaging indexes should be detected regularly for drinkers, so as to make early diagnosis, early treatment and improve prognosis.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R575.5
本文編號：2284186
[Abstract]:Objective to analyze the clinical records of patients with alcoholic liver disease (alcoholic liver disease,ALD) in Qinghai area, to explore the incidence of alcoholic liver disease, and to summarize its clinical characteristics and prognosis, so as to improve the understanding of ALD and to make early diagnosis. Early treatment of ALD provides clinical basis. Methods from January 2008 to November 2013, the clinical records of 201 patients with ALD diagnosed in the affiliated Hospital of Qinghai University were retrospectively analyzed. To analyze the relationship among age, occupation, obesity, alcohol consumption, drinking time and ALD in the three groups of alcoholic fatty liver (alcoholic fatty liver,AFL), alcoholic hepatitis (alcoholic hepatitis,AH) and alcoholic cirrhosis (alcoholic cirrhosis,AC). To compare the differences of biochemical and imaging indexes among the three groups, to analyze the causes of hospitalization and death of some ALD patients, and to analyze the relationship between Maddrey function and the different condition and prognosis of ALD. Results the prevalence age of AFL was mainly between 31 and 40 years old, that of AH and AC group was between 41 and 50 years old, that of workers and cadres drinking alcohol was more, and that of AFL group was mainly obesity. The incidence of ALD was related to the amount of alcohol consumed and the time of drinking. There was a significant difference in alcohol consumption between the three groups (p < 0. 05), but there was no significant difference between the drinking time groups (p > 0. 05). There was significant difference in liver function test between AST/ALT,A/G,TCH,TG,HDL groups (p < 0. 05). With the exacerbation of liver damage, the level of AST/ALT decreased gradually, while AST/ALT increased gradually. There was significant difference in portal vein blood flow velocity between the two groups (p < 0. 05), and it slowed down with the exacerbation of liver damage, but there was no significant difference between the two groups (p > 0. 05). ALD). The main cause of hospitalization and death in patients with liver cirrhosis was the late complications of cirrhosis, and there was no significant difference between the two groups (p > 0. 05). Upper gastrointestinal bleeding was the first. The scores of Maddrey function in patients with different conditions and prognosis were significantly different (p < 0. 05). Conclusion in Qinghai, men are the main patients with ALD, the clinical characteristics are not specific, the condition and prognosis of ALD are related to long-term heavy drinking, the Maddrey function is closely related to the severity of the disease and prognosis. The primary cause of hospitalization and death in patients with ALD is upper gastrointestinal hemorrhage, and the related biochemical and imaging indexes should be detected regularly for drinkers, so as to make early diagnosis, early treatment and improve prognosis.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R575.5
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