| ObjectiveTo explore the etiological trend and clinical characteristics of 860 patients who were hospitalized for the first time in cirrhosis in recent 10 years,so as to provide help for early prevention and early diagnosis and treatment of liver cirrhosis.Material and MethodsThe inpatient medical record databases of Fist Affiliated Hospital of one University were collected for all individuals admitted with a new diagnosis of liver cirrhosis during January 2007 and December 2016.During this period,there were a total of 10,367 cases invovlved in the diagnosis of cirrhosis,of which the patients who were repeatedly treated with cirrhosis in our hospital only collected their first hospitalization.Excluding patients who had been admitted to our hospital for the first time but had been diagnosed with cirrhosis in other hospitals,860 patients who met the criteria were included in this study.Results1.The constituent ratio of the main causes of liver cirrhosis among the total 860liver cirrhosis cases,hepatitis B(55.7%),alcoholic liver disease(14.4%),cryptogenic cirrhosis(8.3%),hepatitis B combined with alcoholic liver disease(7.6%),hepatitis C(5.5%)and autoimmune liver disease(3.5%).2.The changes in the ratio of major causes of liver cirrhosis:a analysis was made by dividing the time into 5 years before and after the January 2012,the proportion of hepatitis B cirrhosis decreased from 60.1%to 51.1%(X~2=7.161,P<0.05)and the proportion of autoimmune cirrhosis significantly increased from 0.7%to 6.4%(X~2=20.958,P<0.01).3.Cirrhosis related complications:in this study,the primary complication of the first inpatients with grade Child-Pugh C cirrhosis was upper gastrointestinal bleeding and the primary complication of the first inpatients with grade Child-Pugh A and Child-Pugh B liver cirrhosis was liver cancer.4.Comparison of blood biochemistry of hepatitis B liver cirrhosis,alcoholic cirrhosis,hepatitis B combined with alcoholic cirrhosis,hepatitis C liver cirrhosis and autoimmune cirrhosis,the level of AST/ALT and GGT in patients with alcoholic cirrhosis were significantly higher than those in patients with cirrhosis due to the other four causes,the level of TBIL in patients with hepatitis B combined with alcoholic cirrhosis was significantly higher than the others and the level of ALP in patients with autoimmune cirrhosis was significantly elevated.5.The causes of death in patients with liver cirrhosis:13 patients died during the hospital stay,the causes of death were hepatic encephalopathy(46.1%),hepatorenal syndrome(23.1%),upper gastrointestinal bleeding(15.4%)and infection(15.4%).6.HBV DNA has been measured in 206 patients with hepatitis B related cirrhosis,35 were HBeAg positive and 171 were negative.There were 104 virus replicator in HBe Ag negative patients and the proportion was 60.8%;there were 30 virus replicator in HBeAg positive patients and the proportion was 85.7%(X~2=7.920,P<0.05).ConclusionsIt is suggested that hepatitis B was the major cause of cirrhosis,the second one was alcoholic liver disease.The proportion of liver cirrhosis caused by hepatitis B was declining and the proportion of autoimmune cirrhosis increased significantly.The primary complication of the first inpatients with grade Child-Pugh C cirrhosis was upper gastrointestinal bleeding and the primary complication of the first inpatients with grade Child-Pugh A and Child-Pugh B liver cirrhosis was liver cancer.HBeAg negative hepatitis B patients still need to detect HBV DNA,timely antiviral treatment.The risk of liver cancer in patients with hepatitis B combined with alcoholic cirrhosis is higher than that of alcoholic cirrhosis,and it is more likely to be associated with diabetes and the prognosis is poor.The increase of GGT and ALP for no cause and clinical manifestation should be paid attention to the exception of autoimmune liver disease,so as to prevent the occurrence of cirrhosis in early stage. |
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