慢性重型病毒性肝炎发病特点的探讨

目的：分析慢性重型肝炎（慢重肝）的发病特点。方法：使用SPASS及STATA软件对520例慢重肝患者的发病特点进行分析。结果：①＜10天、＜2周、2－4周、4周－半年的发生率分别为10．4％、18．1％、17．1％及64．8％；②每组均有40％以上患者无明确的诱因，但30％以上患者有1－3种以上诱因，合并感染的发生率最高，差异有非常显著性（P＜0．01）；③每组均有50％以上患者发生于肝硬化；④每组均有50％以上患者无肝性脑病，而腹水发生率均在75％以上，首先出现肝性脑病均低于5％，而首先出现腹水均在10％以上；⑤每组出现肝性脑病的最晚时间均晚于变重时间。结论：①520例患者均在慢性肝病的基础上逐渐发展成慢重肝的；②慢重肝在发病诱因、基因、肝性脑病发生率及出现时间、首先出现的合并症等方面与无肝病史的急性、亚急性重型肝炎相差较大，应独立命名并需加强研究。

Features of onset of chronic severe hepatitis in 520 cases

Objective To discuss features of onset of chronic severe viral hepatitis (CSH).Methods The patterns of onset of 520 cases of CSH were analyzed by SPASS and STATA software. Results 1. With in less than 10 days, less than 2 weeks, 2 to 4 weeks, 4 weeks to 6 months,10.4%,18.1%,17.1% and 64.8% of 520 cases deteriorated into severe hepatitis respectively. 2. There were no definite predisposing factors in more than 40% cases. There were 1 to 3 or more predisposing foctors in more than 30% cases. The incidence of concurrent infection was the highest ( P <0.01). 3. The pathogenic basis in more than 50% cases was cirrhosis. 4. Hepatic encephalopathy did not occur in more than 50% of the cases. Ascites occurred in more than 75% of cases. Hepatic encephalopathy first occurred in less than 5% cases and ascites in more than 10% of cases. 5. The latest time for occurrence of hepatic encephalopathy was later than the time of deteriorating into severe hepatitis.Conclusion 1. Gradual deterioration into CSH was found in all the 520 cases. 2. The predisposing factors, pathogenic bases, incidence and occurring time of hepatic encephalophy, firstly occurring complication and so on in CSH are not the same as those in acute and subacute severe hepatitis. Therefore, CSH should be independently named and the study of CSH should be strengthened.