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解放军总医院第五医学中心2002年-2018年常见非感染性肝病构成比及变化趋势分析
Constituent ratio and changing trend of non-infectious liver diseases in The Fifth Medical Center of Chinese PLA General Hospital from 2002 to 2018
文章发布日期:2020年07月09日  来源:  作者:何婷婷,景婧,柏兆方,等  点击次数:645次  下载次数:51次

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【摘要】:目的 对比分析住院的4种常见非感染性肝病住院患者2002年-2018年构成比及变化趋势。方法 收集2002年-2018年解放军总医院第五医学中心收治的37 973例非感染性肝病患者[出院病历的病案首页第一诊断为酒精性肝病(n=14 971)、药物性肝损伤(药物性肝损害)(n=11 406)、非酒精性脂肪性肝病(n=1776)和自身免疫性肝病(n=9820)]的病历资料,包括年龄、性别分布特征并对变化趋势进行对比分析。计数资料组间比较采用χ2检验。结果 药物性肝损伤患者占常见非感染肝病患者的30.04%,排在第2位,仅次于酒精性肝病。2011年以前药物性肝损伤患者占总住院肝病患者的比例呈上升趋势,2012年后该构成比开始呈一过性下降趋势。不同年龄段男女分布有显著差异(χ2=113.087,P<0.05)。男性发病年龄主要集中在40~49岁,女性主要集中在50~59岁。不同住院年份的药物性肝损伤男性和女性患者,在不同高发年龄段分布均存在显著差异(男性:χ2=369.252,P<0.001;女性: χ2=663.490,P<0.001)。男性患者发病年龄峰值区间无明显变化,而女性患者发病年龄峰值区间呈老龄化趋势,由原来的40~49岁为主逐渐过渡到近6年的50~59岁年龄段。结论 药物性肝损伤已构成非感染性肝病主要部分,中老年女性为主要高发人群,须重视药物性肝损伤的防控和诊治,尤其是中老年女性群体应加强安全用药指导宣教,建议在服药期间密切监测肝功能。
【Abstract】:Objective To investigate the constituent ratio and changing trend of four common types of non-infectious liver diseases in our hospital from 2002 to 2018. Methods Medical records were collected from 37 973 patients with non-infectious liver diseases who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from 2002 to 2018, and according to the first diagnosis listed in the first page of discharge medical records, 14 971 patients had alcoholic liver disease, 11 406 had drug-induced liver injury, 1776 had nonalcoholic fatty liver disease, and 9820 had autoimmune liver diseases. The distribution characteristics of age and sex and the changing trend were analyzed. The chi-square test was used for comparison of categorical data between groups. Results The patients with drug-induced liver injury accounted for 30.04% of the patients with common non-infectious liver diseases, and it ranked only second to alcoholic liver diseases in all four types. The proportion of patients with drug-induced liver injury among the hospitalized patients with liver diseases tended to increase before 2011, and this constituent ratio showed a trend of transient reduction after 2012. There was a significant difference in sex distribution between the patients with different ages (χ2=113.087, P<0.05). The age of onset was mainly 40-49 years in male patients and 50-59 years in female patients. There were significant differences in the age distribution of drug-induced liver injury between the male and female patients hospitalized in different years (χ2=369.252 and 663.490, both P<0.05). There was no significant change in the range of peak age of onset in male patients, while in female patients, the range of peak age of onset showed an aging trend from 40-49 years to 50-59 years in the recent 6 years. Conclusion Drug-induced liver injury has become a major part of non-infectious liver disease and often occurs in middle-aged and elderly women. The prevention, control, diagnosis, and treatment of drug-induced liver injury should be taken seriously, especially medication guide and education for middle-aged and elderly women, and it is recommended to strengthen the monitoring of liver function during medication.
【关键字】:化学性与药物性肝损伤; 肝疾病,酒精性; 非酒精性脂肪性肝病
【Key words】:chemical and drug induced liver injury; liver diseases,alcoholic; non-alcoholic fatty liver disease
【引证本文】:HE TT, JING J, BAI ZF, et al. Constituent ratio and changing trend of non-infectious liver diseases in The Fifth Medical Center of Chinese PLA General Hospital from 2002 to 2018[J]. J Clin Hepatol, 2020, 36(8): 1773-1777. (in Chinese)
何婷婷, 景婧, 柏兆方, 等. 解放军总医院第五医学中心2002年-2018年常见非感染性肝病构成比及变化趋势分析[J]. 临床肝胆病杂志, 2020, 36(8): 1773-1777.

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