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嗜肝病毒阴性肝病的病因分析
An etiological analysis of liver diseases with negative hepatotropic virus
文章发布日期:2020年11月13日  来源:  作者:郝大昂,刘晔,颜学兵  点击次数:3473次  下载次数:43次

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【摘要】:目的 分析嗜肝病毒阴性肝病的病因,为肝脏疾病的临床诊治提供思路。 方法 回顾性分析2018年7月-2019年12月在徐州医科大学附属医院感染科收治的113例嗜肝病毒阴性肝病患者的临床资料及肝脏穿刺活组织检查结果,根据性别分为男性组(n=41)和女性组(n=72),根据年龄分为青年组(n=42)、中年组(n=56)和老年组(n=15)。计数资料组间比较采用χ2检验。 结果 113例嗜肝病毒阴性肝病患者中,最终明确病因病例111例(98.23%)。非酒精性脂肪性肝病(NAFLD)43例(38.05%)、药物性肝损伤(DILI)40例(35.40%)、自身免疫性肝病(AILD)16例(14.15%)、酒精性肝病(ALD)8例(7.08%)、胆道系统疾病 3例(2.65%)、其他系统疾病累及肝脏 1例(0.88%)。男性患者以NAFLD(53.49%)、ALD(100%)、DILI(15.00%)为主,女性患者以DILI(85.00%)、NAFLD(46.51%)、AILD(93.75%)为主。DILI中女性患者明显多于男性(χ2=40.000,P<0.001),AILD中女性患者也显著多于男性(χ2=12.250,P<0.001)。青年组中,NAFLD(55.81%)、DILI(20.00%)、ALD(75.00%)为主要病因,中年组和老年组均以DILI为主。NAFLD患者中,青年组患者明显多于老年组(χ2=16.333,P<0.001)。DILI患者中,中年组患者明显多于青年组(χ2=8.000,P=0.005)。AILD患者中,中年组患者明显多于青年组(χ2=8.333,P=0.004)。结论 绝大多数嗜肝病毒阴性肝病可通过肝脏活组织病理学检查确诊,NAFLD、DILI、AILD是主要病因。不同性别及年龄组患者的病因构成不同。
【Abstract】:Objective To investigate the etiology of liver diseases with negative hepatotropic virus, and to provide ideas for the clinical diagnosis and treatment of liver diseases. Methods A retrospective analysis was performed for the clinical data and liver biopsy results of 113 patients with negative hepatotropic virus who were admitted to The Affiliated Hospital of Xuzhou Medical University from July 2018 to December 2019. According to sex, they were divided into male group with 41 patients and female group with 72 patients, and according to age, they were divided into youth group with 42 patients, middle-aged group with 56 patients, and elderly group with 15 patients. The chi-square test was used for comparison of categorical data between groups. Results Among the 113 patients with negative hepatotropic virus, 111(98.23%) were given a confirmed diagnosis, among whom 43 (38.05%) were diagnosed with nonalcoholic fatty liver disease (NAFLD), 40(35.40%) were diagnosed with drug-induced liver injury (DILI), 16(14.15%) had autoimmune liver disease (AILD), 8(7.08%) had alcoholic liver disease, 3(2.65%) had biliary disease, and 1(0.88%) had diseases in other systems which involved the liver. Among the male patients, 53.49% had NAFLD, 100% had ALD, and 15% had DILI, while among the female patients, 85% had DILI, 46.51% had NAFLD, and 93.75% had AILD. For DILI, there were significantly more female patients than male patients (χ2=40.000, P<0.001), and for AILD, there were also significantly more female patients than male patients (χ2=12.250, P<0.001). In the youth group, NAFLD (55.81%), DILI (20%), and ALD (75%) were the main causes of disease, and DILI was the main cause in the middle-aged group and the elderly group. Among the patients with NAFLD, there were significantly more patients in the youth group than in the elderly group (χ2=16.333, P<0.001); among the patients with DILI, there were significantly more patients in the middle-aged group than in the youth group (χ2=8.000, P=0.005); among the patients with AILD, there were significantly more patients in the middle-aged group than in the youth group (χ2=8.333, P=0.004). Conclusion Most liver diseases with negative hepatotropic virus can be diagnosed by liver biopsy, and NAFLD, DILI, and AILD are the main causes. Patients with different sexes and ages have different etiologies.
【关键字】:肝疾病; 嗜肝病毒属; 活组织检查,针吸
【Key words】:liver diseases; hepatovirus; biopsy,needle
【引证本文】:HAO DA, LIU Y, YAN XB. An etiological analysis of liver diseases with negative hepatotropic virus[J]. J Clin Hepatol, 2020, 36(12): 2735-2739. (in Chinese)
郝大昂, 刘晔, 颜学兵. 嗜肝病毒阴性肝病的病因分析[J]. 临床肝胆病杂志, 2020, 36(12): 2735-2739.

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