我国北方地区急性、亚急性肝衰竭病因与预后分析

目的 探讨我国北方地区急性、亚急性肝衰竭患者的病因特点及其与预后关系.方法 回顾性分析我院2002年1月至2013年12月收治的655例急性、亚急性肝衰竭患者的病因及转归的相关临床资料.结果 655例急性、亚急性肝衰竭病因构成：病毒感染仍是首要原因,占比38.17％,其次为病因不明36.95％及药物引起（22.75％）.病因变迁：2002年至2005年,病毒感染是急性、亚急性肝衰竭首要病因,占比58.2％～50％,尤其是嗜肝病毒感染（HAV＋ HBV＋ HEV） 53.5％～44.4％.从2006年嗜肝病毒感染明显下降,而不明原因及药物所致呈逐步上升趋势,在2009年不明原因取代病毒感染成为最主要病因.患者总体改善率为34.81％,其中HEV感染所致的预后好于不明原因（P＜0.05）.结论我国北方地区急性、亚急性肝衰竭病因构成发生改变,不明原因所致逐渐增多并取代病毒感染成为最主要病因,不同病因预后不同.

Analysis of etiology and prognosis of acute and subacute liver failure from northern China

Objective To investigate the etiological characteristics and prognosis of patients with acute liver failure（ALF） and subacute liver failure （SALF） from northern China.Methods The clinical data about etiologies and outcomes of 655 patients with ALF and SALF were retrospectively analyzed.Results The etiological constituent ratio of 655 patients with ALF and SALF：viral infection is primary （38.17%）,followed by unknown etiology（36.95%） and drug-induced（22.75%）.The etiology of ALF and SALF is changed,the main cause is viral infection （58.2%-50%） from 2002 to 2005,there into hepatotropic virus was dominant （53.5%-44.4%）.But hepatotropic virus infection were decreased from 2006,unknown etiology and drug-induced were increased gradually.Unknown etiology has replaced viral infection as the most common cause of ALF and SALF.The overall improved rate of ALF and SALF was 34.81%,The prognosis of HEY-infected is significantly better than that of unknown etiology（P 〈 0.05）.Conclusions The etiological constituent ratio of ALF and SALF has changed in northern China,the unknown etiology of ALF and SALF was increased and replaced viral infection as the most common cause.The prognosis of acute and subacute liver failure varies in different etiology.