摘要
目的对隐源性肝炎患者进行肝脏病理学及临床分析，以期为临床诊断及治疗提供参考。方法对566例隐源性肝炎患者行肝脏穿刺活体组织学检查，对其肝脏病理学资料与临床资料进行对比分析。男女比例采用，检验。其余计数资料因呈偏态分布，采用Х^2和检验。结果共收集566例患者资料，其中酒精性肝病175例（30．92％），药物性或环境因素肝损害101例（17．84％），遗传代谢性疾病93例，感染性疾病84例，脂肪性肝炎53例，自身免疫性肝病30例，病理诊断尚不能明确的30例。不同的疾病在性别、年龄分布上差异均有统计学意义，ALT、γ-谷氨酰转移酶水平在不同疾病中的差异均有统计学意义。其中自身免疫性肝病组性别构成与各组比较，q值分别为9．140、7．435、5．071、9．529、12．500，P值均≤0．01；酒精性肝病组、自身免疫性肝病组年龄分别与遗传代谢性疾病组、感染性肝炎组、药物性或环境因素肝损害组、脂肪性肝病组比较，q值分别为17．254、17．523、9．170、7．118以及10．302、10．697、5．266、4．661，P值均≤0．01；酒精性肝病γ-谷氨酰转移酶水平与遗传代谢性疾病、感染性肝炎、药物性或环境因素肝损害组比较，q值分别为8．003、4．793、4．404，P值均≤0．01，差异均有统计学意义。结论病理学分析为隐源性肝炎的明确诊断提供较好的诊断手段，提示在隐源性肝炎患者，年龄、性别及生物化学检测结果等资料可成为诊断的部分依据。
Objective To investigate the etiology, pathology, and clinical characteristics of cryptogenic liver diseases in order to develop a pathogenic profile for clinical diagnosis and therapeutic design. Methods The data of the 566 patients diagnosed with abnormal liver function and who had undergone liver biopsy at our insitute between January 2006 to March 2010 were retrospectively analyzed. The Chi-squared （Х^2） test was used to assess disease correlation with sex and the rank sum test was used to assess disease correlation with continuous data since all data had asymmetric distribution. Results Among the 566 patients, abnormal liver function was attributed to alcoholic liver disease （n = 175; 30.92%）, drug-induced or environmentally- induced liver disease （n = 101; 17.84%）, hereditary and metabolic disease （n = 93; 16.43%）, infectious hepatitis disease （n = 84; 14.84%）, fatty liver disease （n = 53; 9.36%）, and autoimmune liver disease （n = 30; 53.00%）. Thirty patients had unknown etiology, despite liver biopsy analysis. Among these disease subgroups, there were distinct correlations with sex, age, and levels of alanine transaminase （ALT） and 3,-glutamyltransferase （GGT）. The autoimmune liver disease group was correlated with sex （q = 9.14, 7.435, 5.071, 9.529, and 12.5, respectively; P 〈 0.01）. The alcoholic liver disease group and autoimmune liver disease group were correlated with age （vs. genetic metabolic disease group： q = 17.254 and 10.302; infectious hepatitis group： q = 17.523 and 10.697）; drug/environmentally-induced liver damage group： q = 9.170 and 5.266）; fatty liver group： q = 7.118 and 4.661） （P ≤0.01）. In addition, the alcoholic and autoimmune liver disease groups were correlated with GGT levels （vs. genetic metabolic disease group： q = 8.003; infectious hepatitis group： q = 4.793; drug/ environmentally-induced liver damage group： q = 4.404） （P ≤ 0.01）. Conclusion Liver pathology is important for the diagnosis of cryptogenic liver diseases. Patient age, sex, and biochemistry index may facilitate diagnosis and treatment in the absence of pathology.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2012年第4期300-303,共4页
Chinese Journal of Hepatology
