【作者】 武文华；

【导师】 张栩；

【作者基本信息】 宁夏医科大学 ， 内科学， 2009， 硕士

【摘要】 目的:总结我院回族老年病毒性肝炎患者的临床特点,为宁夏回族老年病毒性肝炎的研究提供依据。方法:回顾性分析我院2002年1月至2007年12月期间住院的符合诊断标准的109例回族老年病毒性肝炎患者(为回族老年组)与同期住院的符合诊断标准的374例汉族老年病毒性肝炎患者(汉族老年组)进行职业,肝炎家族史,饮酒史,居住地,病原学分型,临床分型,临床表现,并发症,合并症,实验室检查及预后的对比分析。结果:(1)一般资料比较:回族老年组农民患者有102例(94%),有乙型肝炎家族史者24例(22%),有饮酒史者3例(2.8%);汉族老年组农民患者有146例(39%),有乙肝家族史者33例(8.82%),有饮酒史者39例(10.4%);比较均具有统计学差异(P<0.05)。(2)病原学分型回族老年组以病毒性肝炎乙型为主102例(93.6%);临床分型以慢性肝炎28例(25.6%),肝炎肝硬化为主76例(68.8%)与汉族老年组比较病原学分型及临床分型均无统计学差异。(3)症状体征:回族多以乏力、纳差,黄疸,腹胀,腹水就诊。(4)并发症、合并症以消化、循环、呼吸系统为主,两组比较回族老年较汉族老年原发性肝癌(23.9%)和糖尿病(22%)发生率高,汉族老年上消化道出血(21.1%)及酒精性肝病(7.5%)的发生率较回族老年高,差异均有统计学意义。(5)实验室检查回、汉两组胆红素均较高,两组比较回族老年的胆固醇、血脂、血糖水平高于汉族老年,差异有统计学意义。(6)预后,回族老年组患者无住院死亡,自动出院的情况较多。结论:我院109例回族老年病毒性肝炎患者病例中男性多,乙型肝炎病毒感染多,慢性肝炎、肝炎肝硬化比例高,消化道症状起病多见,黄疸高发,并发症及合并症多等特点与老年病毒性肝炎临床特点相符。但与本组汉族老年患者比较具有农民患者多,乙肝家族史明显;并发症及合并症中原发性肝癌,糖尿病多发;上消化道出血及酒精性肝病发生率低;自动出院患者多的特点。更多还原

【Abstract】 Objeetive: To analysis and evaluate the clinical features of viral hepatitis in old Hui patients in our hospital for the further research on viral hepatitis in old Hui patient in our courtry. Methods: A retrospective study was made on 109 elderly Hui patients who are suitable for the standard with viral hepatitis (group Hui) during the last six years. To analyze occupation, family history of HBV, habit of alcohol, dwelling place, etiology, clinical manifestations,the laboratory data and complications with Han patients (≥60, group Han)with viral hepatitis as controls. Results: (l)There were more farmer patients 102 cases (94%), more patients had family history of HBV 24 cases (22%)and fewer patients 3 cases(2.8%) had the alcohol history in the old Hui patients group while there were 146(39%) farmer patients,33(8.82%)patients had family history of HBV,39(10.4%) patients had the alcohol history in the old Han control group. Compared with above informations there were significant differences(P<0.05). (2) Our study shows that hepatitis B 102 cases (93.6%), chronic hepatitis 28 cases(25.6%), liver cirrhosis,respectively decompensated liver cirrhosis 76 cases(68.8%)were common in old Hui patients the same as the old Han patients; (3) The general symptoms and signs were common in old Hui control group,such as acratia, jaundice, abdominal enlargement, edema, and ascites; (4) The complications and other diseases were both common. Compared with the old Han control group,hepatocellular carcinoma(23.9%)and diabetes mellitu(s22%)were higher than the old Han patients, Upper Gastrointestinal Hemorrhage(21.1%)and alcoholic liver disease(7.5%)were lower than the old Han patients; (5) The liver function tests showed that the blood glucose, triglyceride and cholesterol were higher in the Hui control group. Serum bilirubin were higher in both of the two group. (6)No Hui patients died in hospital but more Hui patients required to discharge when they felt worse or worst. Conclusion: In our study, we find that there were a lot of common clinical features in both groups such as men, HBV, chronic hepatitis, decompensated liver cirrhosis, digestive symptom, jaundice, many complications and other diseases. Meanwhile compared with the Han control group there were also some differences in the old Huis such as more farmer patients, HBV history were obviously, hepatocellular carcinoma and diabetes mellitus were common, fewer old Hui patients had upper gastrointestinal hemorrhage and alcoholic liver disease in our hosptial. More Hui patients were apt to discharge.更多还原