酒精性肝硬化237例临床分析

目的研究酒精性肝硬化(Alcoholiclivercirrhosis,ALC)的发病趋势及临床特点。方法对我院1994年1月～2003年12月住院的237例ALC患者的临床资料进行分析。结果ALC占肝硬化(LC)发病总数的百分比从1994年的10.8%上升至2003年的24%;男女之比为2352;ALC237例患者中腹胀174例(73.8%),乏力、食欲不振143例(60.3%),黄疸59例(24.9%),上消化道出血91例(38.4%),双下肢浮肿86例(36.2%),肝性脑病37例(15.6%),肝癌19例(8%),合并感染36例(15.2%),糖尿病24例(10.1%);肝掌87例(36.7%),蜘蛛痣85例(35.9%),腹水128例(54%),肝大60例(25.3%);肝脏酶学AST/ALT≥2的97例(40.9)%;死亡31例(13%),其中,上消化道出血占74%,肝性脑病占70.9%。结论ALC的发病呈逐年上升趋势,男性占绝大多数,肝脏肿大占一定比例,1/2ALC病例合并胃黏膜糜烂或溃疡,肝脏酶学以AST和GGT升高为主,AST/ALT≥2为诊断ALC的重要参考指标,ALC主要死亡原因是上消化道出血和肝性脑病。

Clinical analysis on 237 cases with alcoholic liver cirrhosis

Objective To study the clinical characteristics of alcoholic liver cirrhosis.Method From January1994to December2003,clinical data of 237cases with ALC were analyzed.Results ALC /LC rised from10.8%of 1994to24%of 2002.Male /female is235/2.Among237ALC,abdominal distension174,anorexia and fatigue143,jaundice59,upper gastrointestinal haemorrhage91,en-cephalopathy37,hepatic cancer19,complicated infection36,diatetes24,pider angilmata85,palma erythema 87,ascites128,enlarged liver60;97cases sera AST /ALT>2.Among31dead cases,74%were caused by upper gastrointestinal haemorrhage and70.9%due to hep-atic encephalopathy.Conclu sio n The incidence of ALC increased gradually from1994to2003.Male is predominantly in ALC.The symptoms and signs of ALC is as same as that of liver cirrhosis (LC).Enlargement of liver in some ALC patients is different from the cotract of liver in almost all LC patients due to viral hepatitis.Rising AST and GGT are more common in ALC.The main causes of deth are upper gastrointestinal haemorrhage and hepatic encephalopathy.