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目的探讨非病毒性肝病的流行病学和临床特点,指导对这组疾病的诊断和治疗。方法对453例非病毒性肝病患者的年龄、性别、临床表现和实验室检查等进行回顾性调查分析。结果脂肪肝居本组各病之首,其次为酒精性肝硬化、自身免疫性肝病(包括PBC、AIH、PSC等)以中年女性为主,患者常有突出的黄疸、皮肤瘙痒、尿黄等胆汁淤积性症状,易出现药物过敏和肝外自身免疫性疾病。脂肪肝、混合性肝硬化、酒精性肝硬化以男性为主。酒精性肝病以蜘蛛痣、肝掌、男性乳腺发育等雌激素均多的体征较为突出。除急性药物性肝病外,生化异常的共同特点为:转氨酶轻、中度升高,AST较ALT异常明显,AST/ALT>1;GGT、ALT和胆红素多有明显升高;自身免疫性肝病的γ-GI升高明显,但γ-GI的升高不具特异性,其升高和患者的病程长短有关。结论脂肪肝、酒精性肝硬化、自身免疫性肝炎、药物性肝炎、原发性胆汁性肝硬化是非病毒性肝病的主要病种;尽早测定AST/ALT、GGT、胆红素及自身抗体等有助于提高这组疾病的诊断率。
Objective To explore the epidemiological and clinical features of non-viral liver disease and to guide the diagnosis and treatment of this group of diseases. Methods 453 cases of non-viral liver disease in patients with age, gender, clinical manifestations and laboratory tests were retrospectively analyzed. Results Fatty liver ranks first in this group with alcoholic cirrhosis, followed by autoimmune liver disease (including PBC, AIH, PSC, etc.). Middle-aged women are the main ones. Patients often have prominent jaundice, pruritus, Cholestasis and other symptoms, prone to drug allergy and extrahepatic autoimmune diseases. Fatty liver, mixed cirrhosis, alcoholic liver cirrhosis mainly men. Alcoholic liver disease to spider nevus, liver palm, male breast development and other signs of estrogen are more prominent. In addition to acute drug-induced liver disease, biochemical abnormalities common features: mild aminotransferase, moderately elevated, AST was significantly more than ALT, AST / ALT> 1; GGT, ALT and bilirubin were significantly increased; autoimmune Liver disease, γ-GI increased significantly, but the rise of γ-GI is not specific, and its rise and duration of the patient’s duration. Conclusions Fatty liver, alcoholic cirrhosis, autoimmune hepatitis, drug-induced hepatitis and primary biliary cirrhosis are the main diseases of non-viral liver disease. AST / ALT, GGT, bilirubin and autoantibodies Help to improve the diagnosis rate of this group of diseases.