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目的 通过对上海市首次入院的慢性肝病患者的调查,了解慢性肝病发生胆汁淤积的流行病学特征,为预防和治疗提供科学依据.方法 纳入上海市2005年4月至2014年9月首次住院的5 146例慢性肝病的患者,回顾性研究患者的临床资料.以碱性磷酸酶(ALP)水平高于1.5倍正常值上限(ULN),且γ-谷氨酰转移酶(GGT)水平高于3倍ULN为胆汁淤积的诊断标准,对胆汁淤积患者在不同年龄、性别、病因或肝病类型中的发生率进行对比分析,并对男女胆汁淤积患者的一般信息及生物化学指标进行比较.据资料不同分别采用t检验或x2检验进行统计学分析.结果 共入组5 146例,剔除486例,因此总计纳入4660例进行研究,胆汁淤积的总发生率为10.26％ (478/4660),男性慢性肝病患者胆汁淤积的发生率随年龄的增加有上升趋势.在不同的慢性肝病中,胆汁淤积的发生率较高为原发性硬化性胆管炎(75.00％)和原发性胆汁性胆管炎(42.86％),其他的依次为肝肿瘤(35.97％)、自身免疫性肝炎(30.77％)、药物性肝病(28.31％)、酒精性肝炎(16.46％)、隐源性肝硬化(13.98％)、血吸虫性肝硬化(12.99％)、酒精性肝硬化(7.53％)、混合性肝硬化(7.32％)、病毒性肝硬化(5.94％)和非酒精性脂肪性肝病(2.70％).这些患者中胆汁淤积的发生率无性别差异,在男女性胆汁淤积的患者中,GGT、总胆红素的均值比较,差异有统计学意义. 结论 住院慢性肝病患者中胆汁淤积的总发生率为10.26％,总体随年龄增加呈上升趋势,原发性硬化性胆管炎和原发性胆汁性胆管炎是发生率最高的疾病,各种慢性肝病胆汁淤积的发生率无明显性别差异.“,”Objective To investigate the epidemiological status of cholestasis in first-hospitalized patients with chronic liver disease in Shanghai,and to provide a scientific basis for developing prevention and treatment measures.Methods From April 2005 to September 2014,5 146 first-hospitalized patients in Shanghai with a diagnosis of chronic liver disease were enrolled in this study.Clinical data of the 4 660 patients who fit the study criteria for participation were collected for retrospective analysis.Diagnosis of cholestasis was made according to serum alkaline phosphatase (ALP) levels higher than 1.5 times the upper limit normal (ULN) and gamma-glutamyltransferase (GGT) levels higher than 3 times the ULN.The incidence rate of cholestasis was assessed for relation to age,sex,etiology,and type of liver disease,and statistically compared to the general clinical data and specific biochemical indicators with potential sexrelated differences.T-test and chi-square test were performed for the statistical analyses.Results Of the 4 660 study participants,10.26％ had cholestasis;the prevalence of cholestasis increased with increasing age in male patients.The distribution of the cholestasis incidence according to the type of chronic liver disease was:75.00％,primary sclerosing cholangitis;42.86％,primary biliary cirrhosis;35.97％,hepatic tumor;30.77％,autoimmune hepatitis;28.31％,drug-induced liver disease;16.46％,alcoholic hepatitis;13.98％,cryptogenic cirrhosis;12.99％,schistosomal cirrhosis;7.53％,alcoholic cirrhosis;7.32％,mixed cirrhosis;5.94％,viral liver cirrhosis;2.70％,nonalcoholic fatty liver disease.There was no significant difference in the prevalence of cholestasis between the two sexes.In the patients with cholestasis,the levels of GGT and total bilirubin were significantly different between the two sexes.Conclusion The incidence rate of cholestasis in firsthospitalized patients with chronic liver disease was 10.26％,and the rate increased with increased age.Patients with primary sclerosing cholangitis or primary biliary cirrhosis had higher incidence rates of cholestasis.Incidence rates of cholestasis of the various chronic liver diseases were not related to sex.