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目的分析酒精性肝衰竭患者临床特点。方法回顾性分析456例酒精性肝衰竭患者的临床特点,与同期394例HBV相关慢加急肝衰竭患者(HBV related acute-on-chronic liver failure,HBV-ACLF)临床特点及转归进行比较。结果酒精性肝衰竭占所有肝衰竭患者的比例呈逐年上升趋势,并且酗酒已成为肝衰竭第二大病因。白蛋白、血红蛋白、血小板、甲胎蛋白、胆碱酯酶、住院时间和MELD等水平酒精性肝衰竭患者比HBV-ACLF患者低(均P<0.01),而GGT水平酒精性肝衰竭患者比HBV-ACLF患者高(P=0.043),而年龄、胆红素、D/T在统计学上无差异(P值分别为0.201、0.094、0.567)。虽然酒精性肝衰竭和HBV-ACLF患者两组间出院好转率比较无差异(P=0.142),但是酒精性肝衰竭相对HBV-ACLF具有更高的住院死亡率(P=0.006)。结论酒精性肝衰竭患者住院占比呈逐年上升趋势,酒精性肝衰竭患者转归差。
Objective To analyze the clinical features of patients with alcoholic liver failure. Methods The clinical features of 456 patients with alcoholic liver failure were retrospectively analyzed. The clinical features and prognosis of 394 patients with HBV-related acute-on-chronic liver failure (HBV-ACLF) were compared. Results The proportion of alcoholic liver failure in all patients with liver failure showed a rising trend year by year. And alcoholism has become the second leading cause of liver failure. Patients with alcoholic liver failure had lower levels of albumin, hemoglobin, platelets, alpha-fetoprotein, cholinesterase, length of hospital stay, and MELD than those with HBV-ACLF (all P <0.01), whereas patients with GGT -ACLF patients (P = 0.043), while age, bilirubin and D / T were not statistically different (P values were 0.201,0.094,0.567 respectively). Although there was no difference in discharge improvement between alcoholic liver failure and HBV-ACLF patients (P = 0.142), alcoholic liver failure had a higher in-hospital mortality rate relative to HBV-ACLF (P = 0.006). Conclusion The proportion of hospitalized patients with alcoholic liver failure has been increasing year by year, and the patients with alcoholic liver failure have worse prognosis.