| Background and ObjectiveAlcoholic liver disease(ALD) is a series of liver lesion of excessive use of alcohol which includes light alcoholic liver disease,alcoholic fatty liver,alcoholic hepatitis,hepatofibrosis and alcoholic cirrhosis(AC).With the development of economy of our country,the aggravation of psychological pressure from society,pre-capita alcohol consumption is increasing,and alcoholic cirrhosis(AC) is showing a increasing tendency to.However,the mechanism of AC is still unknown,and we still lack of the epidemiology information of AC.What is worse,the biochemical index which is special to AC is in short supply.Those reasons stop the study of the diagonosis and treatment of AC.To analyze the clinical data in 160 in-patients with alcoholic cirrhosis in our hospital during January 2005 to October 2008,and to study the morbidity and clinical characteristics,to study AC's epidemiology and influence factors,to explore fairly ideal laboratory test index and therapeutic effect,so as to increase the awareness of AC and provide the scientific references for the dicisions of diagnosis and treatment with AC.Methods1.study object Basing on the ALD diagnosis standards in Hangzhou Meeting held on February,2006.Results,160 paitients with alcoholic cirrhosis in our hospital during January 2005 to October 2008 were chosen.2.Methods The clinical data of 160 patients with AC were analyzed statistically and retrospectively,which included history of alcohol intake,clinical manifestations,liver function tests,radiology results, endoscopy results,complications and couses of death.The 160 cases were divided into two groups,which included compensatory stage and decompensatory stage.The difference significance of biochemical index was compared.The therapeutic effect was compared with posthepatitic cirrhosis which included 172 in-patients in our hospital.The etiological factors of cirrhosis were analyzed by studying the patients who were diagnosed as cirrhosis during 2002 to 2007.3.Statistical method All the date was analyzed by spss15.0 software.The measurement date was descriped by mean±SD,the measurement data was analyzed by pairing t-test and rank-sum test. Ranked date was analyzed by pairing rank-sum test.The significant standard was P＜0.05.Results1 features of AC The percentage of AC is about 7.32%to 10.72% from 2002 to 2007 year.The morbidity of alcoholic liver cirrhosis is increasing annually.2 general conditions Those from 41 to 60 were susceptible.The median age was about 54 years old.The time of intaking alcohol of compensation stage and decompensation stage was 24.8±10.3 years and 28.6±10.8 years and had significant difference(P＜0.05).The quantity of the alcohol intake of the different stages was 142.4±51.4g/l and 185.8±76.8g/l and had significant difference(P＜0.05).3 clinical manifestation of AC There were 112 cases(70%) had abdominal distention,80 cases(50%) of lower extremity,78(47.8%) cases of asthenia,48 cases(30%) of melena,104 cases(43.7%) of sign of ascites, 88 cases(55%) of jaundice,64 cases(40%) of spider nevus,70 cases(43.7%) of liver palm.The rest of manifestation were of no specificity. 4 complication of AC There were 66 cases(41.2%) of spontaneous peritonitis,41 cases(25.6%) of upper gastrointestinal bleeding,40 cases(25%) of infection,38 cases(23.7%) of hepatic encephalopathy,9 cases(5.6%) of primary carcinoma of liver.5 the value of Assistant examination to diagnose AC From US/CT,36(32%)patients was diagnosed as hepatomegaly,78 patients(70%) was diagnosed as splenomegaly,9(5.6%)patients was diagnosed as primary carcinoma of liver.There were 66 patients got gastroscopy,during which,47 patients(73.4%) had esophagus and gastric varices,10 patients(15.6%) had Portal hypertensive gastropathy,13 patients(20.3%) had ulcer.6 Laboratory or Test Results of AC There were 70 cases(43.7%) of AST/ALT＞2,the mean of ALT and AST were 43.78±31.72U/L and 83.53±72.01U/L,they had difference(P＜0.05).80%cases of AC had higher level of GGT.65%cases had higher level of ALP.GGT was higher than ALP(P＜0.05).The value of PT of conpensation stage and decompensation stage were 15.36±1.83 and 19.48±5.21.The value of TBIL were 27.76±20.50μmol/l and 96.60±75.79μmol/l.A/G were 1.04±0.27 and 0.76±0.23.MCV were 91.18±12.22 fl and 96.72±13.09 fl.AST/ALT were 1.66±0.76 and 2.28±1.47.Tests of AST/ALT,PT,TBIL,A/G,MCV had significant difference(P＜0.05) between the two groups.7 conversion and prognosis of AC The main cause of death is the complication of AC,the first was upper gastrointestinal hemorrhage(UGH)(6 cases),the second was hepatic encephalopathy(HE)(6 cases),the third was hepatorenal syndrome(5 cases).In comparison with posthepatitic cirrhosis,patients of AC had better curative effects.The cure rate,efficiency rate,inefficiency and mortality of AC were 0.6%,83.8%,10.6%,5.0%.The cure rate,efficiency rate, inefficiency and mortality of posthepatitic cirrhosis were 0,74.4%,15.1%, 10.4%.Conclusion1 The morbidity of alcoholic liver cirrhosis is increasing.AC has relationship with the long term alcohol abuse history(including the amount and duration of drinking).2 The incidence of liver cancer complicated by AC is less than posthepatitic cirrhosis and alcohol is the pathogen which cannot be ignored of AC3 The ratio of AST/ALT,GGT,ALP can help to diagnosis AC.MCV, PT,TBIL,A/G can reflect the condition of disease.The higher of MCV, PT,TBIL,the lower of A/G,the more advanced disease.4 In comparison with posthepatitic cirrhosis,patients of AC had better curative effects... |
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