Pathogenic factors and clinical characteristics of 104 cirrhosis cases in Shangri-La area, Yunnan

doi:10.16150/j.1671-2870.2022.06.11

Abstract

Abstract:

Objective: To analyze the main etiology and clinical features of cirrhosis in Shangri-La area of Yunnan and provide clinical data for prevention and control in such area. Methods: A total of 104 patients with cirrhosis admitted to the People’s Hospital of Diqing Tibetan Autonomous Prefecture from January 2019 to June 2021 were enrolled, and the etiological composition and main clinical characteristics of patients with cirrhosis in Shangri-La were analyzed retrospectively. Results: Patients with cirrhosis ranged from 33 to 86 years old, with an average age of (59.5±11.3) years old. The male to female ratio was 9 to 4. It revealed that 62.5% patients were Tibetans, 17.31% were Han Nationality, 15.38% were Yi Nationality. For Child-Pugh grading, 38 cases (37%) were with Child-PughA, 56 cases(54%) were with Child-pugh grade B, and 10 cases (9%) cases were with Child-pugh grade C. The main reason for the visit was abdominal distension. For etiological composition, alcoholic cirrhosis accounted for 38%. Hepatitis B cirrhosis accounted for 48%. Hepatitis C cirrhosis accounted for 1%. Mixed sclerosis accounted for 13%. The age of onset of cirrhosis caused by all causes is younger than those in other parts of the country, especially the age of onset of alcoholic cirrhosis is younger and the prognosis remission rate after standard treatment was only 1%. Conclusions: Viral hepatitis is still the main cause of cirrhosis in this region, followed by alcoholic liver disease and mixed cirrhosis. Attention should be paid to the harm of alcohol to human body education in this region, and strengthen the prevention and treatment of viral hepatitis.

Key words: Shangri-la region, Cirrhosis of the liver, Alcoholic liver disease, Hepatitis virus, Cause

CLC Number:

R541.7

YANG Wenkang, ZHANG Jun, WANG Shuqiu, XIANG BA Yangzong, YANG Cuiping. Pathogenic factors and clinical characteristics of 104 cirrhosis cases in Shangri-La area, Yunnan[J]. Journal of Diagnostics Concepts & Practice, 2022, 21(06): 730-734.

Figures/Tables 2

References 26

[1]	林三仁. 消化内科学高级教程[M]. 北京: 人民军医出版社, 2009:377-381.
	Lin S R. Advanced course in digestive medicine[M]. Beijing: People′s Military Medical Publishing House, 2014:377-381.
[2]	葛均波, 徐永健. 内科学[M]. 8版. 北京: 人民卫生出版社, 2013:424-425.
	Ge J B, Xu Y J. Internal Medicine[M]. 8th Ed. Beijing: People′s Medical Publishing House, 2013:424-425.
[3]	中华医学会肝病学分会脂肪肝和酒精性肝病学组. 非酒精性脂肪性肝病诊疗指南(2010年修订版)[J]. 中华肝脏病杂志, 2010, 18(3):163-166.
	Fatty Liver and Alcoholic Liver Disease Group, Chinese Association of Hepatology. Alcoholic Liver Disease Group, Chinese Association of Hepatology. Guidelines for diagnosis and treatment of non-alcoholic fatty liver disease (revised 2010 edition)[J]. J Chin Hepatol, 2010, 18(3):163-166.
[4]	中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2015年版)[J]. 实用肝脏病杂志, 2016, 19(3):389-400.
	Hepatology Branch, Chinese Medical Association, Infectious Diseases Branch of the Chinese Medical Association. Chinese Medical Association, Infectious Diseases Branch of the Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B(2015 version)[J]. J Pract Hepatol, 2016, 19(3):389-400.
[5]	中华医学会肝病学分会, 中华医学会感染病学分会. 丙型肝炎防治指南(2015年更新版)[J]. 临床肝胆病杂志, 2015, 31(12):1961-1979.
	Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for hepatitis C: a 2015 update[J]. J Clin Hepatol, 2015, 31(12):1961-1979.
[6]	刘君, 呼圣娟, 郭建阳, 等. 乙型肝炎病毒相关性肝硬化肝癌与非肝硬化肝癌临床特点对比分析[J]. 临床消化病杂志, 2022, 34(2):115-119.
	Liu J, Hu S J, Guo J Y, et al. Analysis of clinical characteristics of hepatitis B virus associated liver cancer with or without cirrhosis[J]. Chin J Clin Gastroenterol, 2022, 34(2):115-119.
[7]	李玉珍, 孙元培, 廉晓晓, 等. 不同病因肝硬化患者肠道菌群变化研究[J]. 中西医结合肝病杂志, 2022, 32(4):306-310.
	Li Y Z, Sun Y P, Lian X X, et al. Study on the changes of gut microbiota in liver cirrhosis patients with different cause[J]. Chin J Integr Tradit & Med Liver Dis, 2022, 32(4):306-310.
[8]	张云颖, 关霞, 任小平. 病毒性肝炎-肝硬化-原发性肝癌病因形态学及防治策略的研究进展[J]. 癌症进展, 2021, 19(17):1745-1748.
	Zhang Y Y, Guan X, Ren X P. Advances in etiological morphology and prevention strategies of viral hepatitis-cirrhosis-primary liver cancer[J]. Oncol Prog, 2021, 19(17):1745-1748.
[9]	单姗, 赵连晖, 马红, 等. 肝硬化的定义、病因及流行病学[J]. 临床肝胆病杂志, 2021, 37(1):14-16.
	Shan S, Zhao L H, Ma H, et al. Definition, etiology, and epidemiology of liver cirrhosis[J]. J Clin Hepatol, 2021, 37(1):14-16.
[10]	陆再英, 钟南山. 内科学[M]. 7版. 北京: 人民卫生出版社, 2008:446-447.
	Lu Z Y, Zhong N S. Internal medicine[M]. 7th ed. Beijing: People′s Medical Publishing House, 2008:446-447.
[11]	高潇雪, 刘立新. 酒精性肝病流行病学及发病机制研究进展[J]. 中华消化病与影像杂志(电子版), 2016, 6(2):62-65.
	Gao X X, Liu L X. Progress in the epidemiology and pathogenesis of alcoholic liver diseases[J]. Chin J Digest Med Imageol(Electron Ed), 2016, 6(2):62-65.
[12]	杜静园, 颜华东. 不同病因肝硬化失代偿患者临床特征及长期预后危险因素的前瞻性队列研究[J]. 肝脏, 2021, 26(2):140-146.
	Du J Y, Yan H D. A prospective cohort study on the clinical characteristics and risk factors of long-term prognosis in patients with decompensated cirrhosis due to different etiologies[J]. Chin Hepatol, 2021, 26(2):140-146.
[13]	沈自雄, 李敏, 张嵴明, 等. 兰州地区肝硬化的病因构成及临床特征分析[J]. 临床肝胆病杂志, 2020, 36(4):783-787.
	Shen Z X, Li M, Zhang J M, et al. Etiologies and clinical features of liver cirrhosis in Lanzhou, China[J]. J Clin Hepatol, 2020, 36(4):783-787.
[14]	李世焱. 肝硬化的病因及临床特点分析170例[J]. 中国医药指南, 2019, 17(33):150-151.
	Li S Y. Analysis of etiology and clinical features of cirrhosis in 170 cases[J]. Guide China Med, 2019, 17(33):150-151.
[15]	张飞, 张志勇. 763例肝硬化患者的病因及临床特点分析[J]. 临床消化病杂志, 2019, 31(2):89-92.
	Zhang F, Zhang Z Y. Etiology and clinical characteristics of patients with cirrhosis in 763 cases[J]. Chin J Clin Gastroenterol, 2019, 31(2):89-92.
[16]	郑银城, 韩超, 李艳伟, 等. 2012年与2017年3 065例肝硬化病因及其并发症对比分析[J]. 中国实用内科杂志, 2019, 39(3):278-281.
	Zheng Y C, Hab C, LiY W, et al. Comparative study on etiology and complications of liver cirrhosis in a 5-year period[J]. Chin J Pract Intern Med, 2019, 39(3):278-281.
[17]	章燕虹, 李游, 陈龙, 等. 2 890例住院的肝硬化患者病因和并发症分析[J]. 实用肝脏病杂志, 2018, 21(3):344-347.
	Zhang Y H, Li Y, Chen L, et al. Etiology and complications in 2890 patients with liver cihhrosis[J]. J Pract Hepatol, 2018, 21(3):344-347.
[18]	王熙瑶, 刘宁, 文凤, 等. 乙型肝炎肝硬化、酒精性肝硬化和自身免疫性肝硬化凝血相关参数比较[J]. 标记免疫分析与临床, 2021, 28(10):1721-1726.
	Wang X Y, Liu N, Wen F, et al. A Comparison of Coagulation Related Parameters Among Hepatitis B Cirrhosis,Alcoholic Cirrhosis and Autoimmune Cirrhosis[J]. Lab Immunoassay Clin Med, 2021, 28(10):1721-1726.
[19]	钟红梅, 朱金朋, 韩遵文, 等. HCY、AST/ALT、GGT、MCV与酒精性肝硬化的相关性研究[J]. 中国医学工程, 2021, 29(11):27-30.
	Zhong H M, Zhu J P, Han Z W, et al. Correlation between HCY, AST/ALT, GGT, MCV and alcoholic cirrhosis[J]. China Med Eng, 2021, 29(11):27-30.
[20]	萧志勇, 谢平伯, 梁艳. 丁二磺酸腺苷蛋氨酸辅助治疗酒精性肝硬化的效果[J]. 北方药学, 2020, 17(6):72-73.
	Xi Z Y, Xe P B, LIANH Y. Effect of adjunctive treatment of alcoholic cirrhosis by adenosine methionine succinate[J]. J North Pharm, 2020, 17(6):72-73.
[21]	王炳元, 高君. 重视酒精性肝病的诊断与治疗[J]. 北京医学, 2014(3):206-207.
	Wang B Y, Gao J. Pay attention to the diagnosis and treatment of alcoholic liver disease[J]. Beijing Med J, 2014(3):206-207.
[22]	沈德驹. 戒酒综合征25例临床分析[J]. 福建医药杂志, 2011, 33(3):53-54.
	Shen D J. Clinical analysis of 25 cases of alcohol withdrawal syndrome[J]. Fujian Med J, 2011, 33(3):53-54.
[23]	Ginès P, Krag A, Abraldes J G, et al. Liver cirrhosis[J]. Lancet, 2021, 398(10308):1359-1376. doi: 10.1016/S0140-6736(21)01374-X URL
[24]	Andacoglu O, ÖZBEK U, LIU J, et al. Comparison of 1-year morbidity following liver transplant for acute alcoholic hepatitis versus alcoholic cirrhosis[J]. Exp Clin Trans-plant, 2021, 19(5):439-444.
[25]	尹炜, 刘勇鸿. 乙型肝炎肝硬化流行病学调查及预后影响因素分析[J]. 饮食保健, 2019, 6(22):287-288.
	Yin W, Liu Y H. Epidemiological investigation and prognostic factors analysis of hepatitis B cirrhosis[J]. Diet health, 2019, 6(22):287-288.
[26]	赵英妹, 聂红明, 张珏, 等. 肝硬化患者凝血五项的测定及其临床意义[J]. 诊断学理论与实践, 2021, 20(05):480-483.
	Zhao YM, Nie HM, Zhang J, Huang Y. Detection of five coagulation indices in patients with cirrhosis and its clinical significance[J]. Journal of Diagnostics Concepts & Practice, 2021, 20(05):480-483.