酒精性肝硬化患者临床特征分析

doi:10.3969/j.issn.1672-5069.2021.03.027

摘要/Abstract

摘要： 目的总结酒精性肝硬化患者的临床特征。方法 2016年6月～2019年6月我院收治的87例酒精性肝硬化患者和96例乙型肝炎肝硬化患者,接受超声检查,收集临床资料,计算中性粒细胞/淋巴细胞计数比值(NLR),比较两种肝硬化患者临床特点的异同。结果酒精性肝硬化患者男性占比为86.2%,显著高于乙型肝炎肝硬化(70.8%,P<0.05);酒精性肝硬化患者乏力和纳差、蜘蛛痣、面部毛细血管扩张发生率分别为79.3%、43.7%和28.7%,显著高于乙型肝炎肝硬化患者【(分别为56.3%、25.0%和3.1%,P<0.05】,而肝功能分级也显著好于乙型肝炎肝硬化(P<0.05);酒精性肝硬化患者消化道出血和感染等并发症发生率显著低于乙型肝炎肝硬化(P<0.05);酒精性肝硬化患者外周血白细胞计数为(6.2±1.6)×10⁹/L,NLR为(3.5±2.8),显著高于乙型肝炎肝硬化患者【分别为(4.9±1.3)×10⁹/L和(2.6±1.9),P<0.05】;酒精性肝硬化患者血清总胆红素和ALT水平显著低于乙型肝炎肝硬化,而血清GGT和ALP水平分别为(296.5±22.7)U/L和(249.6±48.2)U/L,显著高于乙型肝炎肝硬化患者【分别为(124.4±25.8)U/L和(116.7±30.2)U/L,P<0.05】;酒精性肝硬化患者肝脏体积增大和肝实质回声增强发生率分别为36.8%和86.2%,显著高于乙型肝炎肝硬化(分别为12.5%和52.1%,P<0.05),而锯齿状肝被膜和肝实质不均匀回声发生率分别为26.4%和19.5%,显著低于乙型肝炎肝硬化(分别为75.0%和55.2%,P<0.05)。结论与乙型肝炎肝硬化患者相比,酒精性肝硬化有独特的临床特征,这些有助于临床医生给予针对性的处理。

关键词: 酒精性肝硬化, 临床特征, 中性粒细胞/淋巴细胞计数比值

Abstract: Objective The aim of this study was to summarize the clinical features of patients with alcoholic liver cirrhosis (ALC).Methods A total of 87 patients with ALC and 96 with hepatitis B liver cirrhosis (LC) were admitted to our hospital between June 2016 and June 2019. All patients underwent sonography and peripheral blood neutrophil/lymphocyte count ratio (NLR)] were detected by full-automatic biochemical analyzer.Results The proportion rate of male patients with ALC was 86.2%, significantly higher than 70.8% in patients with LC (P<0.05); the incidences of fatigue and anorexia, ocular spider and facial telanqiectasis in patients with ALC were 79.3%, 43.7% and 28.7%, significantly higher than 56.3%, 25.0% and 3.1% in patients with LC (P<0.05), while the Child-Pugh class was superior to that in patients with LC (P<0.05); the incidences of complications such as GI bleeding and infections in patients with ALC were much lower in patients with LC (P<0.05); the white blood cell count and NLR in patients with ALC were (6.2±1.6)×10⁹/L and NLR为(3.5±2.8), significantly higher than [(4.9±1.3)×10⁹/L and (2.6±1.9), P<0.05] in patients with LC; serum bilirubin and alanine aminotrasaminase levels in patients with ALC were significantly lower than those in patients with LC, while serum glutamyl transpeptidase and alkaline phosphatase levels were (296.5±22.7)U/L and (249.6±48.2)U/L, significantly higher than those in patients with LC [(124.4±25.8)U/L and (116.7±30.2)U/L, respectively, P<0.05]; the proportion of liver enlargement and echo enhancement of liver parenchyma in patients with ALC were 36.8% and 86.2%, significantly higher than 12.5% and 52.1% (P<0.05), while liver capsule serration and heterogeneous echo of liver parenchyma were 26.4% and 19.5%, significantly lower than 75.0% and 55.2% (P<0.05) in patients with LC. Conclusion The patients with ALC has unique clinical feature, which might guide the clinicians to take an appropriate measures dealing with them in clinical practice.

Key words: Alcoholic liver cirrhosis, Clinical feature, Neutrophil/lymphocyte count ratio

李华, 温江华, 吴英春, 潘宇翔. 酒精性肝硬化患者临床特征分析[J]. 实用肝脏病杂志, 2021, 24(3): 411-414.

Li Hua, Wen Jianghua, Wu Yingchun, et al. Clinical features of patients with alcoholic cirrhosis[J]. Journal of Practical Hepatology, 2021, 24(3): 411-414.

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