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目的:分析慢性重型肝炎(慢重肝)的临床发病特点。方法:对257例慢重肝患者的发病过程进行回顾性分析。结果:慢性肝病发展成慢重肝的时间以<2周、2～4周、4周至半年来统计发生率分别为18.1%、17.1%及64.8%;有40.0%以上的患者无明确诱因,但30.0%以上的患者有1～3种以上诱因,合并感染的发生率最高,差异有非常显著性(P<0.01);有50.0%以上患者发生于肝硬化;有50.0%以上患者无肝性脑病,而腹水发生率均在75.0%以上;<2周起病的慢重肝患者中医证型以血瘀血热证为主(58.3%),4周至半年起病的慢重肝患者以肝肾阴虚证、脾肾阳虚证为主(85.1%),而2～4周起病的慢重肝患者各种证型分布较为均衡(P>0.05)。结论:慢重肝均是在慢性肝病的基础上发展而成;其发病诱因、并发症发生率及出现时间、合并症等因素均影响预后。
Objective: To analyze the clinical features of chronic severe hepatitis (chronic severe hepatitis). Methods: The pathological changes of 257 patients with chronic severe hepatitis were retrospectively analyzed. Results: The incidence of chronic liver disease with chronic severe hepatitis was <2 weeks, 2 ~ 4 weeks, 4 weeks to 6 months. The statistical incidence rates were 18.1%, 17.1% and 64.8% respectively. There were no definite causes in 40.0% More than 30.0% of the patients had more than one to three kinds of inducement, the incidence of co-infection was the highest, the difference was significant (P <0.01); more than 50.0% occurred in patients with cirrhosis; more than 50.0% of patients without hepatic encephalopathy , While the incidence of ascites were more than 75.0%; <2 weeks of onset in patients with chronic severe liver blood stasis syndrome (58.3%), 4 weeks to six months of onset of severe liver disease in patients with liver and kidney Yin deficiency syndrome, spleen and kidney yang deficiency syndrome (85.1%), while 2 to 4 weeks of onset of chronic severe hepatitis patients showed a more balanced distribution of various syndromes (P> 0.05). Conclusions: Both chronic severe hepatitis and chronic liver disease develop on the basis of chronic liver disease. The incidence of the disease, the incidence of complications, the appearance time and the complication all affect the prognosis.