肝病住院患者疾病谱变迁及临床分析

发布时间：2018-04-29 13:05

本文选题：肝病 + 疾病谱　；参考：《皖南医学院》2017年硕士论文

【摘要】：目的:分析皖南医学院弋矶山医院2002—2015年近14年肝病住院患者的疾病谱变迁并探讨其疾病谱变迁的原因,为今后肝病住院患者的预防、治疗及管理提供循证依据。方法:采用回顾性分析方法,收集2002年1月至2015年12月于弋矶山医院住院治疗的肝病患者的临床资料,共8301例,其中病毒性肝炎6405例,运用SPSS 19.0软件及流行病学方法,对肝病住院患者各病种的例数及构成比进行分析和处理,并分析各病种年龄及性别分布情况。结果:2002-2015年间,该院住院治疗的肝病患者中,最多见的是病毒性肝炎,其次为DILI、酒精性肝病、AILD、脂肪肝、血吸虫性肝病以及其他肝病,其占肝病住院患者总例数的比值分别为77.16%、5.88%、3.02%、2.31%、1.30%、1.28%、9.05%)。此14年间该院肝病住院患者例数总体上呈逐年增加的趋势。住院患者中病毒性肝炎的人数每年均排在其他肝病的首位,但其所占肝病住院患者比值呈持续性下降趋势,占比值均在70%以上;不同年度,药物性肝病住院患者例数逐年增加,但其在肝病患者中的比值相对较稳定,基本维持在5%左右;酒精性肝病的占比值自2006年起呈缓慢上升趋势,最高上升至5.65%;自身免疫性肝病的占比曲线整体上呈上升趋势,所占肝病住院患者的比值由0(2002年)上升至3.63%(2015年);脂肪肝的占比曲线波动幅度较小,相对较为稳定,各年度构成比基本维持在1%左右。血吸虫性肝病的占比曲线波动较大,其占比值最低为0,最高为3.59%(2014年)。在病毒性肝炎患者中,以乙型肝炎为主,约占病毒性肝炎住院人数的86.63%,但其在病毒性肝炎住院患者中的占比值大体上呈下降趋势,丙型病毒性肝炎的占比值在2002-2011年间明显增加,2012年起小幅度下降,最低下降至6.72%(2015年);甲型及戊型肝炎的占比曲线表现出下降的趋势。在乙型病毒性肝炎中,慢性乙型病毒性肝炎仍然占主要部分,占比值为45.02%,值得注意的是,2002-2015年间,急性乙型病毒性肝炎在乙型病毒性肝炎住院患者中的占比值呈明显下降趋势,所占比值由20.00%(2002年)下降至5.42%(2015年),乙肝肝硬化及肝癌(乙肝所引起的肝癌)的占比整体上呈上升趋势,慢性乙型病毒性肝炎在乙型病毒性肝炎住院患者中的占比值呈先上升后下降趋势,最低下降至30.17%(2015年),肝衰竭(HBV感染所致)的占比近年来亦呈小幅下降趋势。各肝病住院患者,除AILD及药物性肝病以女性多见外,其他各病种均以男性比较多见,其中酒精性肝病男女之比为40.8:1,自身免疫性肝病男女之比为1:6.68。各病种住院患者基本上均以中年人多见,病毒性肝炎主要集中在青中年人,其比例依次为33.47%、52.05%;酒精性肝病患者主要集中在中年人,占73.31%,其次为老年人、青年人,各占13.94%、12.75%。结论:2002-2015年间,该院肝病住院患者的疾病谱存在变迁,住院病毒性肝炎患者的人数虽然每年均在其他肝病的首位,但是其总体的构成比正在下降;非感染性肝病中,药物性肝病及自身免疫性肝病住院病例数逐年增加,酒精性肝病在肝病住院患者中的构成比近几年有所增加。值得注意的是,病毒性肝炎中,丙型肝炎的构成比在2002-2011年显著上升;乙型肝炎住院患者中,慢性乙型肝炎和急性乙型肝炎构成比呈显著下降趋势,乙型肝炎后肝硬化和乙肝相关肝细胞癌仍有较高的构成比。自身免疫性肝病及药物性肝病以中年女性多见,其他各病种基本上以中年男性多见。
[Abstract]:Objective: to analyze the changes of the disease spectrum changes of the hospitalized patients with liver disease during the last 14 years from 2002 to 2015 in Wangnan Medical College, and to explore the causes of the changes in the disease spectrum, and provide evidence-based evidence for the prevention, treatment and management of the hospitalized patients with liver diseases in the future. Methods: the retrospective analysis method was used to collect the hospital from January 2002 to December 2015. The clinical data of the patients with liver diseases treated by hospital were 8301 cases, of which 6405 cases of viral hepatitis. The number and composition of the various diseases in the patients with liver disease were analyzed and treated with SPSS 19 software and epidemiological methods, and the age and sex distribution of various diseases were analyzed. The most common cases were viral hepatitis, followed by DILI, alcoholic liver disease, AILD, fatty liver, schistosomiasis liver disease and other liver diseases, which accounted for 77.16%, 5.88%, 3.02%, 2.31%, 1.30%, 1.28%, 9.05% in hospitalized patients with liver disease. The number of hospitalized patients in the hospital in the 14 years was increasing year by year. The number of viral hepatitis is ranked first in the other liver diseases every year, but the ratio of the hospitalized patients with liver disease is more than 70%. In different years, the number of hospitalized patients with drug-induced liver disease is increasing year by year, but the ratio of the patients in the liver disease is stable, and it is basically maintained at about 5%. The ratio of the occupation of autoimmune liver disease was up to 5.65% since 2006, and the proportion of the proportion of autoimmune liver disease was rising from 0 (2002) to 3.63% (2015), and the proportion of the proportion of fatty liver was relatively small and relatively stable, and the ratio of each year was basically maintained at 1% left. The ratio curve of the right. Schistosomiasis liver disease fluctuates greatly, the lowest ratio is 0, the highest is 3.59% (2014). In the patients with viral hepatitis, hepatitis B is the main factor, accounting for 86.63% of the number of hospitalized viral hepatitis patients, but the ratio of the hepatitis B in the patients with viral hepatitis is generally declining, and the ratio of the hepatitis C virus. There was a significant increase in 2002-2011 years, a small decrease in 2012, the lowest drop to 6.72% (2015), and a downward trend in the ratio curve of hepatitis A and HEV. In hepatitis B, chronic hepatitis B is still the main part of hepatitis B, accounting for 45.02%. It is worth noting that, during 2002-2015 years, acute B virus The ratio of hepatitis B in patients with hepatitis B was obviously decreased, the ratio of HBV decreased from 20% (2002) to 5.42% (2015). The proportion of HBV liver cirrhosis and liver cancer (HB liver cancer) was on the whole, and the ratio of chronic hepatitis B in patients with hepatitis B was in the ratio. The trend was first and then decreased to 30.17% (2015). The proportion of liver failure (HBV infection) was also decreasing in recent years. All the patients with liver disease, except for AILD and drug liver disease, were more common in men, and the ratio of male and female to alcoholic liver disease was 40.8:1 and autoimmune liver disease. The ratio of male and female to 1:6.68. in all patients was mostly seen in middle-aged people. Viral hepatitis was mainly concentrated in middle-aged and middle-aged people, the proportion in turn was 33.47%, 52.05%. Alcoholic liver disease was mainly concentrated in middle-aged people, accounting for 73.31%. The second was old people, young people, each accounted for 13.94%, 12.75%. conclusion: the hospital liver disease was hospitalized in 2002-2015 years. The number of patients with viral hepatitis is in the first place in other liver diseases every year, but the overall composition ratio is decreasing; in non infectious liver diseases, the number of hospitalized cases of drug-induced liver disease and autoimmune liver disease is increasing year by year, and the composition of alcoholic hepatopathy in the hospitalized patients with liver disease has been compared in recent years. Increase. It is worth noting that in viral hepatitis, the composition of hepatitis C is significantly increased in 2002-2011 years; in patients with hepatitis B, the proportion of chronic hepatitis B and acute hepatitis B is significantly decreased, and there is still a higher constituent ratio in HBV and HBV related hepatocellular carcinoma. Physical liver disease is more common among middle-aged women, and most of the other diseases are middle-aged men.

【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575

【参考文献】