2002至2011年中国“北方”地区住院肝硬化患者病因构成及变化趋势分析

目的：分析2002年至2011年10年间中国“北方”地区住院肝硬化患者病因构成及变化趋势。方法对我院过去10年出院第一诊断为肝硬化的53092例患者的病因构成及变化趋势进行分析。结果乙型肝炎、丙型肝炎、酒精和自身免疫性肝病为前4位的病因，分别占74.2%、10.8%、5.8%和3.9%；乙型肝炎肝硬化的构成比从2002年的81.5%下降至2011年的66.8%，而酒精性肝硬化从2002年的3.3%上升至2011年的7.7%，10年间上升了2.3倍；自身免疫性肝病肝硬化患者多为女性（84.3%），而乙型肝炎肝硬化和酒精性肝硬化患者男性占绝大多数，分别占80.1%和98.0%，差异有统计学意义（P〈0.01）；酒精性肝硬化患者与乙型肝炎肝硬化患者的平均年龄均不足50岁，而丙型肝炎肝硬化、自身免疫性肝病肝硬化患者的平均年龄均在50岁以上，差异有统计学意义（P〈0.01）；患者的籍贯以华北地区最多；4种常见病因所致的肝硬化患者的好转率均在70%以上，酒精性肝硬化和自身免疫性肝病肝硬化患者好转率接近80%，差异有统计学意义（P〈0.01）。结论乙型肝炎、丙型肝炎、酒精和自身免疫性肝病是肝硬化前4位的病因，乙型肝炎肝硬化的构成比在逐年下降，而酒精性肝硬化的构成比在不断上升。

Etiologic changes in patients with liver cirrhosis from 2002 to 2011 in North China

Objective To analyze the changes in cirrhotic etiologies of inpatients from 2002 to 2011 in North China. Methods Cirrhotic etiologies and its changes were analyzed in 53092 patients with liver cirrhosis for the first time in our hospital from 2002 to 2011. Results Hepatitis B related cirrhosis （74.2%）,hepatitis C related cirrhosis （10.8%）,alcoholic cirrhosis （5.8%） and auto-immune liver diseases related cirrhosis （3.9%） were the top four etiologies;The percentage of hepatitis B related cirrhosis was decreased from 81.5% in 2002 to 66.8% in 2011,while the percentage of alcoholic cirrhosis was increased from 3.3% to 7.7%,a 2.3-time increase in 10 years;Patients with auto-immune liver diseases related cirrhosis were mainly female （84.3%） and patients with hepatitis B related cirrhosis and alcoholic cirrhosis were mainly male（80.0% and 98.0%,respectively,P〈0.01）;The average age was less than 50 years in patients with alcoholic cirrhosis and hepatitis B related cirrhosis, while the average age was greater than 50 years old in patients with hepatitis C related cirrhosis and auto-im-mune liver diseases related cirrhosis （P〈0.01）;For all patients,North China ranked first in patient’s family regis-ter,but for patients with alcoholic cirrhosis and auto-immune liver diseases related cirrhosis,Beijing and East Chi-na ranked the second and third place,respectively,in patient’s family register;The top three places accounted for 79.7% of patients with alcoholic cirrhosis;The improvement rate were greater than 70% in patients with the top four etiologies related cirrhosis,and the improvement rate were even higher （80%） in patients with alcoholic cir-rhosis and auto-immune liver diseases related cirrhosis （P〈0.01）. Conclusions Hepatitis B,hepatitis C,alcohol and auto-immune liver diseases are the top four etiologies of liver cirrhosis. The percentage of hepatitis B related cirrhosis is gradually decreasing,while the percentage of alcoholic cirrhosis is increasing from 2002 to 2011 in North China.