肝硬化合并高血压患者的临床特征分析

目的分析肝硬化患者合并高血压的临床特征。方法选取2008年1月-2010年12月于中国医科大学附属第一医院住院的797例肝硬化患者,比较肝硬化患者中高血压的患病率与普通人群高血压患病率的差异,以及合并高血压和不合并高血压与肝脏功能和血清离子之间的关系。结果肝硬化患者合并高血压组的患病率为4.14%,明显低于普通人群高血压患病率(18.80%)(χ2=112.064,P0.001);肝硬化合并高血压组血清门冬氨酸氨基转移酶(64.85±57.13)U/L、碱性磷酸酶(117.30±70.47)U/L和总胆汁酸(31.29±30.72)U/L等均低于肝硬化未合并高血压组,后者分别为(92.30±135.48)U/L(t=-2.159)、(147.19±135.98)U/L(t=-2.153)和(53.50±61.10)U/L(t=-3.227)(P均0.05),而血清白蛋白(33.98±11.29)g/L则高于肝硬化未合并高血压组(31.15±7.44)g/L(t=1.991,P0.05);胆红素代谢功能、凝血功能和血清离子等比较,在两组之间差异无统计学意义。结论肝硬化患者合并高血压的患病率明显低于普通人群,合并高血压时部分肝功能损伤低于未合并高血压者,合并高血压可能延缓肝硬化进展。

Analysis of the clinical characteristics of liver cirrhosis complicated with hypertension

Objective To analyze the clinical characteristics of liver cirrhosis complicated with hypertension. Methods 797 cases of cirrhotic patients in the First Affiliated Hospital of China Medical University from Jan. 2008 to Dec. 2010 were selected, the difference of the prevalence of hypertension between general population and cirrhotic patients was compared, the relationship of liver function and serum ionized between liver cirrhosis complicated with hypertension and non-hypertension was detected. Results Among the patients with liver cirrhosis, the prevalence of hypertension was 4.14% , significantly lower than that in general population （18.80%） （χ^2 = 112. 064, P 〈 0.001 ）. Serum aspartate aminotransferase value, alkaline phosphatase value, total bile acid value were （64.85±57.13） U/L, （117.30±70.47） U/L, （31.29±30.72） U/L, respectively among liver cirrhosis complicated with hypertension group, those in cirrhosis unconsolidated hypertension group were （92.30±135.48 ） U/L （t = - 2.159）, （ 147.19±135.98） U/L （ t = -2.153） and （53.50±61.10） U/L （t = -3.227） , respectively. All the indexes were lower in liver cirrhosis complicated with hypertension group （P 〈 0.05）. However, serum albumin was higher in liver cirrhosis complicated with hypertension group than that in cirrhosis unconsolidated hypertension group （33.98±11.29） g/L vs （31.15±7.44） g/L] （t = 1.991, P 〈0.05）. In addition, the indexes of bilirubin metabolism, coagulation, and serum ionized were not different statistically. Conclusion The prevalence of hypertension in patients with liver cirrhosis is obviously lower than the general population. The extent of liver dysfunction is lower than cirrhosis unconsolidated hypertension, and delay the process of liver fibrosis.