| Objectives:In order to understand the epidemiological and clinical characteristics of inpatients with hepatitis B cirrhosis and help appropriate treatment strategies choosing.Furthermore it may provide reference data for future epidemiological investigations and clinical studies.Methods:This study was a single-centered,retrospective and observational study.We collect the data of inpatients of hepatitis B cirrhosis in the Affiliated Hospital of Yunnan province from 2012 to 2021.The demographic data of patients includes gender,age,ethnicity,occupation and family history.Clinical data includes the first consultation department,admission,clinical symptoms and signs,laboratory data,antiviral treatment,Child-Pugh classification,etc.SPSS26.0 software was used for data analysis.Results:1.From January 2012 to December 2021,there were 2914 inpatients of cirrhosis in the hospital.Among them,there were 1176 cases(40.36%)of hepatitis Bcirrhosis,585 cases(20.08%)of alcoholic cirrhosis,and 418 cases(14.34%)of cryptogenic cirrhosis.2.Among the 1176 patients with hepatitis B cirrhosis,the average age of patients was53.77±12.13 years old,and the male to female ratio was 3.45:1.Among the 1176 patients with hepatitis B cirrhosis,52.72% were diagnosed with hepatitis B cirrhosis at first diagnosis,8.93% were diagnosed with hepatitis B to cirrhosis within 5 years,17.26% were diagnosed with hepatitis B to cirrhosis in 5-10 years,and 21.09% were diagnosed with hepatitis B after more than 10 years.In addition,47.96% of the 1176 patients with hepatitis B cirrhosis were agricultural workers,29.34% had a history of alcohol consumption,5.53% had a family history of hepatitis B virus,and 1.70% had a family history of cirrhosis.3.Of 1176 patients with hepatitis B cirrhosis,28.91% were first accepted by general surgery department,24.91% by gastroenterology,and 21.51% by infectious disease department.40.73% of the patients who complained of abdominal distension and abdominal pain were the main complaints of admission,and 23.81% of the patients mainly had hematemesis and melena.4.Among the 1176 patients with hepatitis B cirrhosis,32.48% of the patients were in the compensatory stage,with an average age of 53.22±11.97 years old,and the male to female ratio was 2.94:1.67.52% of the patients were in the decompensated stage,with an average age of 54.03± 12.21 years old,the ratio of male to female is 3.75:1.5.The main complications of 1176 patients with hepatitis B cirrhosis were ascites in622 cases(52.89%),followed by gastrointestinal bleeding in 332 cases(28.23%),and liver failure in 99 cases(8.42%).Moreover,the study found that 288 cases of liver cancer occurred,of which 45.49% were diagnosed as hepatitis B liver cancer at the first visit to the doctor.10.42% of patients were diagnosed from hepatitis B to liver cancer within 5 years.And 20.14% patients were diagnosed from hepatitis B to liver cancer in 5-10 years.23.96% of patients were diagnosed from hepatitis B to liver cancer in more than 10 years.6.Among the 1176 patients with hepatitis B cirrhosis,63.69% of the patients received antiviral therapy,of which the entecavir antiviral regimen accounted for 55.02%,and the antiviral duration was 68(20-192)weeks;tenofovir disoproxil fumarate had20.33%,the antiviral duration was 36(5-77)weeks;lamivudine was 13.09%,and the antiviral duration was 29(8-220)weeks;adefovir dipivoxil was 8.14%,and the antiviral duration was 116(48-220)weeks.268)weeks;telbivudine accounted for1.47%,and the antiviral duration was 112(48-156)weeks.7.Among the 1176 patients with hepatitis B-related liver cirrhosis,407 cases were tested for autoimmune liver-related antibodies.13 cases were positive for anti-mitochondrial antibodies,and 2 cases were positive for anti-liver-kidney microsomal antibody type 1.3 cases were positive for anti-hepatic solute antibody type 1,and Smooth muscle antibody was positive in 2 cases.And the rest of it were negative.311 patients were tested for autoimmune antibodies,of which 42 were positive for antinuclear antibodies and the rest of tests were negative.There were1153 patients(98.04%)who completed the hepatitis B serum antigen antibody detection,and their hepatitis B virus infection patterns were mainly HBsAg(+),anti-HBe(+),and anti-HBc(+).In addition,HBV-DNA was detected in 966 patients with hepatitis B-related cirrhosis,of which 638 were positive for HBV-DNA and 328 were negative for HBV-DNA.The proportion of liver cancer in patients with antiviral duration < 48 weeks was significantly higher than that in patients with antiviral duration from 48 to 240 weeks(P < 0.05).When comparing the duration of treatment,it was found that the positive proportion of HBV-DNA in patients with different antiviral treatments(lamivudine,entecavir,tenofovir disoproxil fumarate)was significantly higher than that of ≥24 weeks of treatment patients(P <0.05).8.Among the 1176 patients with hepatitis B cirrhosis,61 cases(5.19%)died in the hospital,the average age was 61.26±11.78 years old,and the ratio of male to female was 7.71:1.Among them,21 dead patients were complicated with primary liver cancer,20 dead patients were complicated with gastrointestinal bleeding,and 9 dead patients were complicated with liver failure.Conclusions:1.In the past decade,chronic hepatitis B is still the main reason for hospitalization of patients with cirrhosis,followed by alcoholic hepatitis.2.There is a time lag of up to 6 years between the age of diagnosis of cirrhosis and hepatitis B,and the treatment of chronic hepatitis B whether timely or correctly will determine the outcome of cirrhosis.3.The average antiviral time of patients with hepatitis B cirrhosis and liver cancer is short,and insufficient antiviral time will lead to increased risk of decompensation and liver cancer in patients with hepatitis B cirrhosis.4.The proportion of antiviral therapy in patients with hepatitis B cirrhosis in this survey is insufficient and irregular,and it is still necessary to increase the proportion of antiviral therapy and standardize antiviral therapy in clinic.5.Most patients with hepatitis B cirrhosis are not treated at a specialist for the first time,and a small number of patients are not treated with specialist examination.Thus the diagnosis and standardized treatment of hepatitis B cirrhosis still needs to be improved. |
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