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目的比较肝炎后肝硬化和酒精性肝硬化患者临床特点及防治措施。方法选取福州市第二医院2013年3月—2016年2月收治的肝硬化患者210例,根据疾病类型分为乙型肝炎后肝硬化(VC)组126例与酒精性肝硬化(AC)84例。比较两组患者一般资料(包括性别、年龄、病程等)、临床症状及体征(包括面容、腹腔积液、肝区疼痛、腹胀、水肿等症状)、辅助检查[γ谷氨酰转移酶(γ-GT)、天冬氨酸氨基转移酶(AST)/丙氨酸氨基转移酶(ALT)、平均红细胞容积(MCV)、碱性磷酸酶(ALP)、白球比(A/G)、总胆红素(TBIL),肝右叶斜径]及并发症[上消化道出血(UGB)、肝肾综合征(HRS)、原发性肝癌(HCC)、肝性脑病(HE)、自发性腹膜炎(SBP)等]。结果 AC组患者男性占比高于女性,且高于VC组,差异有统计学意义(P<0.05);AC组年龄低于VC组,差异有统计学意义(P<0.05);两组患者病程比较,差异无统计学意义(P>0.05)。VC组患者蜘蛛痣、面部毛细血管扩张、肝掌、男性乳房发育、肝肿大发生率低于AC组,面色晦暗、脾肿大发生率高于AC组,差异有统计学意义(P<0.05)。VC组患者γ-GT、AST/ALT、ALP、MCV、肝右叶斜径低于AC组,两组患者A/G、TBIL比较,差异无统计学意义(P>0.05)。VC患者HCC发生率高于AC组,SBP低于AC组,差异有统计学意义(P<0.05);两组患者UGB、HRS、HE发生率比较,差异无统计学意义(P>0.05)。结论结合VC和AC患者各自的临床特征,予以目的明确的防治措施,能够获得较为理想的防治效果。
Objective To compare the clinical features and prevention and treatment of patients with cirrhosis and alcoholic cirrhosis after hepatitis. Methods A total of 210 patients with cirrhosis who were admitted to Fuzhou Second Hospital from March 2013 to February 2016 were divided into 126 cases with cirrhosis (VC) group and 126 cases with alcoholic liver cirrhosis (AC) according to the type of disease example. General information (including gender, age, course of disease, etc.), clinical symptoms and signs (including face, ascites, liver pain, abdominal distension, edema and other symptoms) -GT, AST / ALT, MCV, ALP, A / G, total cholesterol TBIL, Slope of the right lobe of liver and complications such as upper gastrointestinal bleeding (UGB), hepatorenal syndrome (HRS), primary hepatocellular carcinoma (HCC), hepatic encephalopathy (HE), spontaneous peritonitis (SBP), etc.]. Results The proportion of males in AC group was higher than that in female group, which was significantly higher than that in VC group (P <0.05). The age of AC group was lower than that in VC group (P <0.05) There was no significant difference in duration (P> 0.05). The incidence of spider nevus, facial telangiectasia, liver palms, male breast development and hepatomegaly in VC group was lower than that in AC group, the dull complexion and splenomegaly were higher in AC group than in AC group (P <0.05) ). There was no significant difference in the A / G and TBIL between the two groups (P> 0.05). The mean value of γ-GT, AST / ALT, ALP and MCV in the VC group was lower than that in the AC group. The incidence of HCC in VC patients was higher than that in AC patients and SBP was lower than that in AC patients (P <0.05). There was no significant difference in the incidence of UGB, HRS and HE between the two groups (P> 0.05). Conclusion Combined with the clinical features of patients with VC and AC, we can give a clear prevention and control measures to achieve the desired effect of prevention and treatment.