155例酒精性肝病患者临床特征分析*

doi:10.3969/j.issn.1672-5069.2017.01.016

实用肝脏病杂志 ›› 2017, Vol. 20 ›› Issue (1): 60-64.doi: 10.3969/j.issn.1672-5069.2017.01.016

155例酒精性肝病患者临床特征分析^*

叶茂聪, 李阳, 肖丽, 杨秀珍, 耿爱文, 沈美龙, 咸建春, 徐洪涛

225300 江苏省泰州市南通大学附属泰州市人民医院肝病科

收稿日期:2016-07-05 出版日期:2017-01-20 发布日期:2017-02-10
通讯作者: 徐洪涛,E-mail:xuhongtao0001@sina.com
作者简介:叶茂聪,男,25岁,硕士研究生。主要从事酒精性肝病和乙型肝炎的诊断与治疗学研究。E-mail:272004940@qq.com
基金资助:
江苏省干部保健科研课题（编号：BJ14032）

Clinical features of patients with alcoholic liver disease:An analysis of 155 cases

Ye Maocong, Li Yang, Xiao Li, et al.

Department of Hepatology,Taizhou People's Hospital,Nantong University,Taizhou 225300,Jiangsu Province,China

Received:2016-07-05 Online:2017-01-20 Published:2017-02-10

摘要/Abstract

摘要： 目的分析酒精性肝病（ALD）的临床特点,进一步提高ALD的诊治水平。方法对2014年1月~2015年7月在泰州市人民医院住院的155例ALD患者的临床资料进行回顾性分析。结果在155例患者中,酒精性脂肪肝（AFL)24例（15.5%）,酒精性肝炎（AH)83例（53.6%）,酒精性肝硬化（AC）48例（31.0%）;农民和个体经营者分别占34.8%和21.9%;平均年龄为（55.5±12.2）岁,45~59岁中年占44.5%;AC患者的平均年龄为（63.1±12.3）岁,显著大于AFL患者的（49.7±7.2）岁和AH患者的（52.9±11.3）岁（P<0.05）;AC患者的乙醇摄入量为（157.5±69.3） g/d,显著大于AFL患者的（105.7±50.6）g/d和AH患者的（125.3±66.4）g/d（P<0.05）;AC患者的平均饮酒年限为（31.7±12.0）年,显著长于AFL患者的（22.6±6.7）年和AH患者的（22.9±10.1）年（P<0.05）;多元回归分析显示,年龄、乙醇摄入量和饮酒年限是ALD患者发生肝硬化的危险因素; 69.0% 患者血清GGT升高,17.4%患者AST/ALT比值>2,38.1%患者红细胞平均体积（MCV）增大。结论 ALD患者主要为中年男性,以农民和个体经营者为主。年龄、乙醇摄入量和饮酒年限为ALD发生肝硬化的危险因素。AST/ALT比值>2、GGT升高和MCV增大还很难作为ALD的临床特点加以应用。

关键词: 酒精性肝病, 临床特点, 危险因素, AST/ALT比值

Abstract: Objective To summarize the clinical characteristics of patients with alcoholic liver disease（ALD）. Methods The clinical data of 155 patients with ALD were retrospectively analyzed from January 2014 to July 2015 in the Taizhou People's Hospital. Results Out of 155 cases,there were alcoholic fatty liver（AFL） in 24, alcoholic hepatitis（AH） in 83 and alcoholic cirrhosis（AC） in 48. The farmers and self-employed businessmen accounted for 34.8% and 21.9%,respectively;The average age was （55.5±12.2） yr old,middle-aged （45 to 59 yr old） were 44.5%;The average age of patients with AC was （63.1±12.3） yr old,significantly greater than （49.7±7.2） yr old in patients with AFL or （52.9±11.3） yr old in patients with AH （P<0.05）;The average ethanol intake in patients with AC was（157.5±69.3） g/d,significantly higher than（105.7±50.6） g/d in patients with AFL or（125.3±66.4） g/d in patients with AH（P<0.05）;The average drinking period in AC patients was （31.7±12.0） yrs,significantly longer than （22.6±6.7） yrs in patients with AFL or（22.9±10.1） yrs in patients with AH（P<0.05）;Logistic analysis showed that the age,ethanol intake and drinking period were independent risk factors for alcoholic liver cirrhosis;serum elevated GGT levels was found in 69.0%,increased erythrocyte mean corpuscular volum （MCV） was in 38.1 % and ratio of AST/ALT>2 was in only 17.4%. Conclusions Patients with ALD were mainly in middle-aged men. Age,ethanol intake and drinking period are risk factors for liver cirrhosis in ALD patients. The ratio of AST/ALT,serum GGT levels and MCV are not good indicators for patients with ALD, and the diagnosis might be dependent on comprehensive clinical data.

Key words: Alcoholic liver disease, Clinical characteristics, Risk factor, Ratio of AST/ALT

叶茂聪, 李阳, 肖丽, 杨秀珍, 耿爱文, 沈美龙, 咸建春, 徐洪涛. 155例酒精性肝病患者临床特征分析^*[J]. 实用肝脏病杂志, 2017, 20(1): 60-64.

Ye Maocong, Li Yang, Xiao Li, et al.. Clinical features of patients with alcoholic liver disease:An analysis of 155 cases[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(1): 60-64.

参考文献

[1] 中华医学会肝病学分会脂肪肝和酒精性肝病学组. 酒精性肝病诊疗指南（2010年修订版）. 中华肝脏病杂志,2010,3（18）:167-169.
[2] Mathurin P,Bataller R. Trends in the management and burden of alcoholic liver disease. J Hepatol,2015,62（1）:38-46.
[3] World Health Organization. Global status report on alcohol and health 2014. http://www.who.int/substance_abuse/publications/glo-
bal_alcohol_report/en.pdf [Accessed 12 May 2014].
[4] World Health Organization. 58th World Health Assembly. Agenda Item 13.14. Public health problems caused by harmful use of alcohol. http：//www.who.int/gb/ebwha/pdf_files/wha58/A58_18_en.pdf [Accessed 15 December 2005].
[5] Rocco A,Compare D,Angrisani D,et al. Alcoholic disease: liver and beyond. World J Gastroenterol,2014,20（40）:14652-14659.
[6] Park BJ,Lee YJ,Lee HR. Chronic liver inflammation: clinical implications beyond alcoholic liver disease. World J Gastroenterol,2014,20（9）:2168-2175.
[7] Liangpunsakul S,Haber P,McCaughan G. Alcoholic liver disease in Asia,Europe,and North America. Gastroenterology,2016,150（8）:1786-1797.
[8] Schwartz JM,Reinus JF. Prevalence and natural history of alcoholic liver disease. Clin Liver Dis,2012,16（4）:659-666.
[9] Lhachimi SK,Nusselder WJ,Smit HA,et al. Prevalences of the life-style related risk factors alcohol,BMI,and smoking:a quantitative health impact assessment. BMC Public Health,2016,16:734.
[10] Mendez-Sanchez N,Villa AR,Chavez-Tapia NC,et al. Trends in liver disease prevalence in Mexico from 2005 to 2050 through mortality data. Ann Hepatol,2005,4（1）:52-55.
[11] European Association for the Study of the Liver. EASL clinical practical guidelines:management of alcoholic liver disease. J Hepatol,2012,57（2）:399-420.
[12] Deleuran T,Vilstrup H,Becker U,et al. Epidemiology of alcoholic liver disease in Denmark 2006-2011:a population-based study. Alcohol Alcohol,2015,50（3）:352-357.
[13] 延华,张粉利,高艳琼,等. 饮酒与酒精性肝病流行病学调查研究. 陕西医学杂志,2015,44（7）:917-918,920.
[14] 姚锦慧,赵秋冬,熊鹏芬,等. 云南元江少数民族酒精性肝病调查. 胃肠病学和肝病学杂志,2011,20（12）:1137-1139.
[15] 李艳华. 蒙古族酒精性肝病的临床流行病学调查. 中国实用医药,2014,9（12）:271-272.
[16] 厉有名,陈卫星,虞朝辉,等. 浙江省酒精性肝病流行病学调查概况. 中华肝脏病杂志,2003,11（11）:647-649.
[17] 刘阳,迟宝荣. 酒精性肝硬化237例临床分析. 吉林医学,2004,25（4）:40-42.
[18] 邹正升,赵军,王晓霞,等. 住院的酒精性肝病患者临床疾病特点分析. 实用肝脏病杂志,2014,17（1）:26-29.
[19] 朱冰,刘鸿凌,刘利敏,等. 4132例酒精性肝病临床特征分析. 中华肝脏病杂志,2015,23（9）:680-683.
[20] Ramos-Lopez O,Martinez-Lopez E,Roman S,et al. Genetic,metabolic and environmental factors involved in the development of liver cirrhosis in Mexico. World J Gastroenterol,2015,21（41）: 11552-11566.
[21] 张龙玉,闫亮,郝书理,等. 乙醛脱氢酶2 基因多态性与酒精性肝病患者饮酒特点和疾病发生的关系. 实用肝脏病杂志,2016,19（3）:292-296.
[22] 厉有名. 酒精性肝病的流行病学特点. 实用肝脏病杂志,2012,15（6）:180-182.
[23] 王炳元. 重视增龄的肝脏衰老. 实用肝脏病杂志,2015,18（6）:571-572.
[24] Campillod B,Richardet JP,Bories PN. Validation of body mass index for the diagnosis of malnutrition in patients with liver cirrhosis. Gastroenterol Clin Biol,2006,30（10）:1137-1143.
[25] Tolstrup JS,Grфnbaek M,Tybjaerg-Hansen A,et al. Alcohol intake,alcohol dehydrogenase genotypes,and liver damage and disease in the Danish general population. Am J Gastroenterol,2009,104（9）:2182-2188.

155例酒精性肝病患者临床特征分析^*

Clinical features of patients with alcoholic liver disease:An analysis of 155 cases

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