肝脏 ›› 2025, Vol. 30 ›› Issue (8): 1108-1110.

• 其他肝病 • 上一篇    下一篇

近30年来重型肝炎病因的变迁及临床特点

张燕, 朱晓红, 梁栋   

  1. 450042 河南郑州 联勤保障部队第九八八医院感染科
  • 收稿日期:2024-05-17 发布日期:2025-09-19
  • 通讯作者: 梁栋,Email:324256854@qq.com

Etiological changes and clinical characteristics analysis of severe hepatitis in a tertiary hospital in the past 30 years

ZHANG Yan, ZHU Xiao-hong, LIANG Dong   

  1. Department of Infectious Diseases, 988 Hospital of Joint Logistics Support Force, Zhengzhou 450042, China
  • Received:2024-05-17 Published:2025-09-19
  • Contact: LIANG Dong,Email:324256854@qq.com

摘要: 目的 回顾性分析近30年来重型肝炎患者病因变化、临床特点及预后。 方法 收集1995年2月至2024年1月联勤保障部队第九八八医院收治的821例重型肝炎患者的临床资料,分析其致病因素、临床类型、生存率。 结果 在2015年之前,引起重型肝炎的病因主要为HBV感染,占71.6%(470/656);近10年来,以酒精性、药物性、免疫性重型肝炎居多,分别占30.9%(51/165)、24.2%(40/165)、10.9%(18/165),差异有统计学意义(P<0.05)。致病因素不同,临床类型也有明显差异,HBV所致的主要为慢加急性重型肝炎,占73.0%(363/497),其他病毒和药物所致以急性和亚急性重型肝炎为主,分别占50.7%、50.6%,而酒精、免疫和代谢因素所致则多表现为慢加急性重型肝炎,分别占67.5%(56/83)、61.8%(21/34)、44.8%(13/29),差异有统计学意义(P<0.05)。 结论 30年来重型肝炎发病率逐渐减少,常见致病因素由病毒转变为酒精、药物及免疫,随治疗方法的多元化及更新,患者生存率逐年提高。

关键词: 重型肝炎, 致病因素, 生存率, 回顾性研究

Abstract: Objective To retrospectively analyze the changes in the etiology of severe hepatitis patients in our hospital over the past 30 years, as well as the clinical characteristics and prognosis differences in different years and etiologies. Methods Clinical data of 821 patients with severe hepatitis admitted to our hospital from February 1995 to January 2024 were collected. They were divided into three groups (Group A, B, and C) based on their year of hospitalization, and their pathogenic factors, clinical types, and survival rates were compared and analyzed. Results Before 2015, the main etiology of severe hepatitis was hepatitis B virus infection, accounting for 71.6%. In the past 10 years, alcoholic, drug-induced, and immunological severe hepatitis were the most common, accounting for 30.9%, 24.2%, and 10.9%, respectively, with statistically significant differences (P<0.05). The pathogenic factors are different, and there are significant differences in clinical types. The main cause of HBV virus was chronic and acute severe hepatitis, accounting for 73.0%. Acute and subacute severe hepatitis were mainly caused by other viruses and drugs, accounting for 50.7% and 50.6%, respectively. Alcohol, immune, and metabolic factors were mostly manifested as chronic and acute severe hepatitis, accounting for 67.5%, 61.8%, and 44.8%, respectively, with statistical significance (P<0.05). Conclusion Over the past 30 years, the incidence of severe hepatitis has gradually decreased, and common pathogenic factors have shifted from viruses to alcohol, drugs, and immunity. With the diversification and updating of treatment methods, patient survival rates have been increasing year by year.

Key words: Severe hepatitis, Pathogenic factors, Survival rate, Retrospective study