| Background and purpose In recent years,Because of the improvement of people,s health consciousness and medical level,and the spread of hepatitis B vaccine,the disease spectrum of liver dysfunction in China has changed significantly.The proportion of abnormal liver function caused by non-viral causes is getting higher and higher.Even according to statistics,about 5%-10%of patients with chronic liver disease can still not determine the cause by routine examination or non-invasive examination.This medical status indicates that clinicians must paying attention to the diagnosis of the cause of the disease,not only must master the clinical characteristics of the disease,routine examination methods,but also need to improve the detection methods,timely identify the cause,reduce the incidence of advanced liver disease and improve the prognosis.The main purpose of this study was to analyze the clinical features of unexplained liver dysfunction in our hospital,and to conduct liver histopathological examination of such patients,to evaluate the value of liver penetration in the diagnosis of unexplained liver function abnormalities,and to probide a new way for the diagnosis and treatment of diffcult liver diseases.Methods(1)Patients who have been admitted to the Department of Infectious Di seases and Gastroenterology in our hospital from January 2014 to December 2017 are selected for detailed medical history,physical examination,and admission routine(blood,urine,fecal routine and inflammation,indicatorscoagulation,biochemical,tumor),(A,B,C,E)hepatitis related virus indicators,autoantibodies and liver dise ase related antibodies,combined with Bultrasound?CT.if necessary,routine MR I or MRCP examination,exclude routine examination clear medical history of heart,lung,spleen,stomach and kidney,as well as liver disease caused by confirme-d viral hepatitis,cirrhosis,alcoholic liver disease,autoimmune liver disease,liver occ upying lesions,stones and bile duct obstruction Abnormal dysfunction.A total of 118 patients with unexplained causes were included in the study.There were 42 males and 76 females with an age range of 16-84 years,with an average age of50.1±13.2 years.(2)Record the gender,age,clinical manifestations,personal history and past history(including drinking history,medication history)and family history of each patient.(3)Patients were informed of the risks and complications before liver puncture.After obtaining informed consent,the 118 patients who were inclu-ded in the study underwent B-ultrasound liver biopsy and the pathological result-s of liver puncture were recorded.(4)Combined with pathological results,analyze whether there is statistical difference in gender and age of patients with the sa-me cause type.Results Among the 118 patients,106 patients with unexplained liver dysfunction were diagnosed by liver biopsy,including 50 cases of autoimmune liver disease(42.37%),including 17 cases of autoimmune hepatitis(AIH)(14.41%).),17 cases of primary biliary cirrhosis(PBC)(14.41%),3 cases of primary sclerosing cholangitis(PS-C)(2.54%),4 cases of overlap syndrome(3.39%),and 4 cases the overlap syndrome was PBC with AIH,and there were 28 cases(23.73%)of acute and chronic hepatitis,including 5 cases(4.24%)acute hepatitis and 23 cases(19.49%)chronic hepatitis and drug-induced liver damage in 23 cases(19.49%).),1 case(0.85%)of metabolic dis-eases(hereditary hemochromatosis),hepatic amyloidosis,cholestatic liver disease,nonalcoholic fatty liver disease and alcoholic hepatitis.12 cases(10.17%)are still unclear Cause.Conclusion This study showed that the main causes of abnormal liver function were autoimmune liver disease(42.37%),acute and chronic hepatitis(23.73%),and drug-induced liver damage(19.49%).Further confirm the diagnostic value of liver biopsy pathology for unexplained liver function abnormalities. |
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