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目的对全国酒精性肝病发病情况、临床特征等进行多中心回顾研究。方法按酒精性肝病诊疗指南标准,将全国7家医院2000—2004年902例确诊为酒精性肝病患者纳入研究。回顾调查酒精性肝病患者占同期住院肝病患者的构成比,分析酒精性肝病的易感因素。结果2000-2004年,酒精性肝病患者占同期住院肝病患者的病例构成比分别为2.4%、2.7%、2.8%、3.4%和4.3%;酒精性肝病以40～49岁者居多,每日摄入乙醇量为80～159 g,饮酒年限以20～29年者居多;轻症酒精性肝病101例(11.2%),酒精性脂肪肝204例(22.6%),酒精性肝炎260例(28.8%),酒精性肝硬化337例(37.4%)。酒精性肝硬化组的饮酒量、饮酒年限与其他三组差异有统计学意义(P<0.05)。酒精性肝病患者常见临床表现为乏力、纳差、黄疸、腹胀、腹痛等;血清学改变以天冬氨酸转氨酶、丙氨酸转氨酶、γ谷氨酰转肽酶、胆红素升高为主。约19.7%患者出现乙醇相关性精神障碍表现,11.9%出现乙醇戒断综合征,10.8%有乙醇性肌病表现;乙醇性心肌和胰腺损害分别占4.6%和3.1%;0.3%有乙醇性性功能障碍表现。结论酒精性肝病占同期住院肝病患者构成比呈逐年上升趋势,肝脏损害程度与饮酒量、饮酒年限相关,长期大量饮酒可造成多器官功能受损。
Objective To conduct a multicenter retrospective study on the incidence and clinical features of alcoholic liver disease in China. Methods According to the guidelines of diagnosis and treatment of alcoholic liver disease, 902 cases diagnosed as alcoholic liver disease in 7 hospitals in China from 2000 to 2004 were included in the study. A retrospective investigation of patients with alcoholic liver disease accounted for the same period the proportion of hospitalized patients with liver disease, alcohol susceptibility analysis of liver disease. Results Between 2000 and 2004, the proportion of cases with alcoholic liver disease accounted for 2.4%, 2.7%, 2.8%, 3.4% and 4.3% of patients with hospitalized liver disease in the same period. Alcoholic liver disease was mostly seen in 40- to 49-year- The alcohol consumption was 80-159 g and the drinking time was 20-29 years. There were 101 cases of mild alcoholic liver disease (11.2%), 204 cases of alcoholic fatty liver disease (22.6%), 260 cases of alcoholic hepatitis (28.8% ), 337 cases of alcoholic cirrhosis (37.4%). Alcohol consumption of cirrhosis group, drinking time and the other three groups were statistically significant differences (P <0.05). Patients with alcoholic liver disease common clinical manifestations of fatigue, anorexia, jaundice, abdominal distension, abdominal pain, etc .; serological changes to aspartate aminotransferase, alanine aminotransferase, γ glutamyl transpeptidase, bilirubin-based . Alcohol-related mental disorders were found in about 19.7% of patients, alcohol abstinence syndrome in 11.9%, alcoholic myopathy in 10.8%, alcoholic myocardial and pancreatic lesions accounted for 4.6% and 3.1%, respectively, and ethanol in 0.3% Dysfunction performance. Conclusions The proportion of alcoholic liver disease in hospitalized patients with liver disease over the same period showed an upward trend year by year. The extent of liver damage was related to the amount of alcohol consumed and the number of years of drinking. Long-term heavy drinking caused multiple organ dysfunction.