| Objective To explore the risk factors of viral hepatitis-related cirrhosis and to investigate the risk factors and trend of cirrhosis in hospitalized patients,and to provide recommendations for prevention and treatment strategies and measures.Methods In this study,a case-control study was conducted among the patients with viral hepatitis-related cirrhosis and chronic hepatitis B(CHB)and chronic hepatitis C(CHC)in five hospitals in Hebei,Jilin,Henan,Guangdong and Shanxi provinces,the history of viral hepatitis,the cognition of viral hepatitis,the related behavior habits and laboratory test results were collected and analyzed by unconditional logistic regression analysis.At the same time,a historical medical records analysis was conducted,the demographic characteristics,the main diagnosis,and the diagnosis of discharge in the hospitalized patients with liver cirrhosis during 2011 to 2015 were collected from three hospitals in Hebei,Guangdong and Shanxi provinces,the risk factors of cirrhosis and its changing trend were analyzed.Results1.The case-control study:The questionnaires collected in the case group and the control group were both 109.In the case group and the control group,the average age were 52.2 ± 11.3 and 48.6 ± 10.9 years old,subjects of males were 75(68.8%)and females were 34(31.2%),Han nationality were 100(91.7%)and 106(97.2%),HBV infectors were 84(77.1%)and HCV infectors were 25(22.9%).Multi variate Logistic Regression analysis showed that alcohol intake(OR=2.13,95%CI:1.01?4.49)was a risk factor,53(48.6%)subjects in the case group and 34(31.2%)subjects in the control group.Smoke(OR=2.31,95%CI:1.04?5.16)was also a risk factor,55(50.5%)subjects in the case group and 31(28.4%)subjects in control group.Senior high school graduate and above(OR=0.42,95%CI:0.20-0.87),adhere to antiviral therapy(OR=0.39,95%CI:0.20?0.75)and exercise(OR=0.23,95%CI:0.07?0.82)were protective factors for viral hepatitis related cirrhosis.Subjects of senior high school graduate and above,adhere to antiviral therapy and exercise in the case group were 34(31.2%),33(30.3%)and 4(3.7%),in the control group were 60(55.0%),59(54.1%)and 18(16.5%).2.The historical medical records analysis:A total of 6421 medical records of cirrhosis hospitalized patients were collected,including 3171(49.4%)cases in Hospital A in Hebei,1059(16.5%)cases in Hospital D in Guangdong and 2191(34.1%)cases in Hospital E in Shanxi.The average age of hospitalized patients was 54.3 years old,4379(68.2%)cases were male and 2042(31.8%)cases were female,the sex ratio was 2.1:1.The risk factors of cirrhosis includes 3049(47.5%)cases of hepatitis B,483(7.5%)cases of hepatitis C and 42(0.7%)cases of HBV/HCV infection.There were no significant changes in the compositions of the three risk factors from 2011 to 2015(p>0.05).Viral hepatitis-related cirrhosis in the compensatory period were 1804(50.5%)cases,and in the decompensated period were 1770(49.5%)cases.There were 2427(67.9%)cases with complications,of which HCC were 736(29.9%)cases and upper gastrointestinal bleeding were 468(19.3%)cases.The number of patients with type 2 diabetes mellitus was the highest of the patients with complications.Conclusion In this study,alcohol intake and smoke are risk factors leading to viral hepatitis-related cirrhosis,antiviral treatment and higher education are protective factors to prevent the occurrence and development of liver cirrhosis.Viral hepatitis is the most important risk factors of hospitalized patients with cirrhosis,49.5%of patients with viral hepatitis-related cirrhosis were decompensated cirrhosis and 67.9%of patients with various complications.It is recommended to enhance the awareness and ability of public health education of medical personals,and promote patients to understand the risk factors affecting liver health and change the bad habits,and promote regular test and adhere to antiviral therapy. |
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