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目的探讨儿童肝病病因分布情况。方法对本院2005年1月-2008年12月收治的197例确诊为肝病患儿的病史、临床表现、实验室检查进行回顾性分析,了解儿童肝病病因学分布情况。结果巨细胞病毒(CMV)肝炎68例,病毒性肝炎60例,非酒精性脂肪性肝病(NAFLD)33例,药物性肝病29例,遗传代谢性肝病4例(肝豆状核变性3例、肝内胆管囊性扩张症1例),EB病毒肝炎2例,自身免疫性肝病1例。CMV肝炎是1岁以下(58/60例,96.67%)婴儿肝病最常见病因,1岁以上以甲型肝炎(31例)、乙型肝炎(26例)为主。同时,NAFLD(33例)及药物性肝病(29例)也逐渐增多,主要发生于4岁以上儿童。结论儿童肝病病因多种多样,病因分布不断变化;儿童肝病仍以病毒性为主,NAFLD及药物性肝病也逐渐增多。
Objective To investigate the distribution of etiology of childhood liver disease. Methods A retrospective analysis was conducted on the history, clinical manifestations and laboratory tests of 197 children diagnosed with liver disease admitted from January 2005 to December 2008 in our hospital. The etiology distribution of children with liver disease was analyzed. Results 68 cases of cytomegalovirus (CMV) hepatitis, 60 cases of viral hepatitis, 33 cases of non-alcoholic fatty liver disease (NAFLD), 29 cases of drug-induced liver disease, 4 cases of genetic metabolic liver disease (Wilson’s disease in 3 cases, 1 case of intrahepatic biliary cystic dilatation), 2 cases of Epstein-Barr virus hepatitis and 1 case of autoimmune liver disease. CMV hepatitis is the most common cause of liver disease in infants under 1 year old (58/60 cases, 96.67%), with hepatitis A (31 cases) and hepatitis B (26 cases) over 1 year old. At the same time, NAFLD (33 cases) and drug-induced liver disease (29 cases) also gradually increased, mainly occurred in children over the age of 4 years. Conclusion There are many causes of liver disease in children and the distribution of etiology is changing. Children with liver disease are still predominantly viral and NAFLD and drug-induced liver disease are gradually increased.