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目的探讨儿童非病毒性肝病占儿童肝病的比例、疾病谱及构成比,为儿童非病毒性肝病的防治提供依据。方法回顾性分析2001年1月—2010年12月在我院住院且进行肝脏活体组织病理检查的儿童非病毒性肝病703例,并与1983年6月—2000年12月病例作比较。结果①2001年1月—2010年12月儿童非病毒性肝病占同期儿童肝病的17.53%,比例逐年上升,尤其近2年达20%以上,与1983年6月—2000年12月儿童非病毒性肝病构成比相比,χ2=38.129,P=0.000。②2001年1月—2010年12月儿童非病毒性肝病疾病谱为66种,以肝脏代谢相关性疾病最多(46.23%)[其中单病种以肝豆状核变性最多(48.92%)],其次为胆道相关性疾病(11.66%)、药物性肝炎(10.53%)和非酒精性脂肪性肝病(7.54%)。③儿童非病毒性肝病重叠病毒性肝炎的比例为11.23%,不容忽视。④4.83%的儿童非病毒性肝病疑难病例通过基因等特殊检查得到确诊。结论①我国儿童非病毒性肝病病例近十年来快速增多,疾病谱迅速扩大,构成比与以往有明显的改变,且与病毒性肝炎重叠的病例不少见,值得注意。②诊断技术的进步和完善,促进了儿童非病毒性肝病疑难病例的确诊。
Objective To explore the proportion of children with non-viral liver disease in children with liver disease, disease spectrum and composition ratio for the prevention and treatment of non-viral liver disease in children provide the basis. Methods A retrospective analysis of 703 children with non-viral liver disease hospitalized in our hospital from January 2001 to December 2010 for liver biopsy was performed and compared with the cases from June 1983 to December 2000. Results ① From January 2001 to December 2010, children with non-viral liver disease accounted for 17.53% of children with liver disease over the same period, the proportion increased year by year, especially in the past two years up to 20% or more, with June 1983 -2000 in December non-viral children Compared with the constitution of liver disease, χ2 = 38.129, P = 0.000. ② From January 2001 to December 2010, 66 kinds of disease spectrum of non-viral liver disease were found in children, with liver metabolism-related diseases accounting for the highest (46.23%) [of which single disease was the most hepatolenticular degeneration (48.92%)], followed by Biliary-related diseases (11.66%), drug-induced hepatitis (10.53%) and non-alcoholic fatty liver disease (7.54%). ③ children with non-viral hepatitis overlap viral hepatitis ratio was 11.23%, can not be ignored. ④4.83% of the difficult cases of non-viral liver disease in children by gene and other special tests have been diagnosed. Conclusion ① The number of children with non-viral liver disease in our country has increased rapidly in recent ten years, and the disease spectrum has rapidly expanded. It is worth noting that the constitutional ratio is obviously changed from the past and the cases overlap with viral hepatitis are not uncommon. ② The improvement and improvement of diagnostic techniques have promoted the diagnosis of difficult cases of non-viral liver disease in children.