老年急性、亚急性肝炎的临床特点、病因及预后研究

目的 分析与探讨老年急性肝炎与亚急性肝炎的临床特点、病因以及预后情况。方法 选取该院2006年3月-2012年3月收治的老年急性肝炎患者共78例作为AH （Acute Hepatitis）组，老年亚急性肝炎患者共92例作为 SH（Subacute Hepatitis）组，对两组患者的临床资料进行回顾性分析，以了解老年急性肝炎与亚急性肝炎的临床特点、病因以及预后情况。结果 老年急性肝炎与亚急性肝炎患者性别分布均为男性高于女性，急性肝炎患者的年龄分布与亚急性肝炎患者的年龄分布差异有统计学意义（P〈0.05）。两组患者的凝血指标、总胆红素水平均差异有统计学意义（P〈0.05）。两者病因基本相同，差异无统计学意义（P〉0.05）。急性肝炎患者的并发症发生率前3位分别为肝性脑病、电解质紊乱以及脑水肿，而亚急性肝炎患者并发症发生率前3位分别为肝腹水、电解质紊乱以及肝性脑病。两组患者发生不同并发症后的死亡率差异有统计学意义（P〈0.05）。结论 老年急性肝炎与亚急性肝炎在年龄分布、凝血功能、总胆红素水平等临床特点以及并发症类型、死亡率等预后方面的差异性较大，应作为两种独立的疾病进行诊断与治疗。

Study on the Clinical Characteristics,Pathogeny and Prognosis of Acute Hepatitis and Subacute Hepatitis in Elderly Patients

Objective To analyze and investigate the clinical characteristics, pathogeny, and prognosis of the elderly patients with acute hepatitis or subacute hepatitis. Methods 78 elderly patients with acute hepatitis admitted in our hospital from March, 2006 to March, 2012 were selected as the AH （Acute Hepatitis） group, and 92 cases of elderly patients with subacute hepatitis were chosen as SH （Subacute Hepatitis） group. The clinical data of the two groups of patients were analyzed retrospectively, so as to understand the characteristics, pathogeny and prognosis of senile acute hepatitis and senile subacute hepatitis. Results Both of these two groups had the same sex distribution which showed that the number of male patients was more than that of female patients, the difference in age distribution between the two groups was statistically significant （P〈0.05）. The coagulation indexes and total bilirubin level of two groups had significant differences （P〈0.05）. The pathogenies of two groups were almost the same with no statistically significant difference （P〉0.05）. Hepatic encephalopathy, electrolyte disturbances and brain edema were the top three complications of AH group, and liver ascites, electrolyte disturbances and encephalopathy were the top three complications of SH group. The difference in death rates between two groups of patients after having different complications was statistically significant （P〈0.05）. Conclusion Senile acute hepatitis and senile subacute hepatitis have significant differences in clinical characteristics such as age distribution, coagulation function, total bilirubin level and the prognosis including type of complications and mortality rate and so forth, so that the two diseases should be diagnosed and treated as two kinds of independent diseases.