2 073例老年肝病病因和预后特点分析

目的分析老年肝病的病因和预后特点。方法回顾性分析我院近5年来收治的老年（t〉60岁）肝病病因和预后特点，采用同期住院的中年和青年肝病病例作为对照。结果老年肝病2073例，占同期成人肝病的10．5％。其中病毒性肝炎导致的青、中和老年肝病所占的比例依次降低，分别为93．01％、90．25％和81．48％；隐源性肝病则依次升高，分别为2.77％、3．46％和6．95％。老年病毒性肝炎病因前三位依次是乙型肝炎（乙肝）、丙型肝炎（丙肝）和戊型肝炎（戊肝），分别占55.47％、16．45％和6．42％，与中年患者一致，青年患者则为乙肝（83．37％）、丙肝（3．20％）、甲肝（2．43％）；青、中和老年肝衰竭的发生率分别是5．19％、8．20％和7．77％（X^2=55．48，P=0．001）。青、中、老年肝病的治愈率依次降低（42.91％、24.33％和19．32％）。结论老年肝病原因以HBV、HCV和HEV感染为主，预后较中、青年患者差。

Etiologies and prognosis in 2073 cases of elderly patients with liver diseases

Objective To investigate the etiologies and prognosis in elderly patients with liver diseases, Methods A retrospective study was made on 2 073 elderly patients with liver diseases （≥60, group E） to analyze the etiologies and prognosis, with middle-aged patients（group M） and young patients （group Y）with liver diseases as controls. Results Of all the patients with liver diseases, group E accounted for 10,5%. Viral hepatitis contributed to liver diseases in 93,01% of patients in group Y, in 90.25% of patients in group M and in 81.45% of patients in group E. Cryptogenic infection was found in 2.77%, 3.46% and 6.95% of patients in the 3 groups, respectively, HBV （55.47%）, HCV （16.45%） and HEV （6.42%） rank the first three entiologies of patients in group E and M, while HBV （88.37%）, HCV （3.20%） and HAV（2.43%） in group Y, Furthermore, 161 of 2 073（7.77%） patients in group E had a liver failure, which was higher than that in group Y （5.19%）, but lower than that in group M（8.20%） （X^2=55.48, P=0.001）, In group E, the curative rate was 19.32%, which was significantly lower than that in group M and Y（24,33%, 42.91%）. Conclusions The main etiologies in group E are HBV, HCV and HEV, and the prognosis in group E is worse than that in group Y and group M.