首页|703例肝内胆汁淤积症的临床特征分析

703例肝内胆汁淤积症的临床特征分析

Clinical Characteristics of Intrahepatic Cholestasis: Analysis of 703 Patients

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背景:肝内胆汁淤积症是一种常见的临床表现,且常伴有黄疸,探讨不同程度黄疸的临床特征有助于加强对肝内胆汁淤积症的认知.目的:探讨肝内胆汁淤积症伴黄疸患者的临床特征.方法:回顾性分析703例肝内胆汁淤积症患者的一般资料、生化指标、病因构成和药物治疗情况.结果:共168例(23.9%)患者发生黄疸,其中轻度黄疸149例、中度黄疸15例,重度黄疸4例.黄疸组ALT、AST、ALP、GGT、DBIL、TBIL、DBIL/TBIL比值、TBA水平均显著高于非黄疸组(P<0.05).不同程度黄疸组ALT、AST、DBIL、TBIL、TBA水平相比差异有统计学意义(P<0.05),而ALP、GGT、DBIL/TBIL比值无明显差异(P>0.05).肝内胆汁淤积症伴黄疸患者的病因以消化系统肿瘤、心血管疾病、休克、血液病、原发性胆汁性胆管炎多见.肝内胆汁淤积症的治疗药物主要为熊去氧胆酸和S-腺苷甲硫氨酸.结论:对于肝内胆汁淤积症患者,随着黄疸的出现和加重,ALT、AST、ALP、GGT水平明显升高,应警惕肝细胞损伤;肝内胆汁淤积症伴黄疸的病因涉及全身各器官和系统,恶性肿瘤、心血管疾病、休克、原发性胆汁性胆管炎为其主要病因.
Background:Intrahepatic cholestasis is a commonly seen clinical manifestation, and often accompanied with jaundice.Study on clinical characteristics of patients with different degrees of jaundice is helpful for the acknowledge of intrahepatic cholestasis.Aims:To explore the clinical characteristics of intrahepatic cholestasis with jaundice.Methods:General data, biochemistry parameters, etiology and treatment of 703 patients with intrahepatic cholestasis were retrospectively analyzed.Results:Jaundice occurred in 168 patients (23.9%), including 149 mild jaundice, 15 moderate jaundice and 4 severe jaundice.Levels of ALT, AST, ALP, GGT, DBIL, TBIL, ratio of DBIL/TBIL, TBA were significantly increased in jaundice group than in non-jaundice group (P<0.05).Levels of ALT, AST, DBIL, TBIL, TBA were statistically different between groups with different degrees of jaundice (P<0.05), however, no significant differences in ALP, GGT, ratio of DBIL/TBIL were seen (P>0.05).The main etiology of intrahepatic cholestasis were digestive system tumors, cardiovascular diseases, shock, hematologic diseases and primary biliary cholangitis.Ursodeoxycholic acid and S-ademetionine were the main drugs for treatment of intrahepatic cholestasis.Conclusions:For patients with intrahepatic cholestasis, levels of ALT, AST, ALP, GGT are increased with the development of jaundice, and attention on damage of hepatocytes should be paid.The etiology of intrahepatic cholestasis with jaundice involves diseases of different organs and systems, most of them are malignant tumor, cardiovascular diseases, shock and primary biliary cholangitis.

CholestasisIntrahepaticJaundiceAlkaline Phosphatasegamma-GlutamyltransferaseEtiologyDrug Therapy

丁婷婷、范秀琴、邹晓平

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南京大学医学院附属鼓楼医院消化内科 210008

胆汁淤积,肝内 黄疸 碱性磷酸酶 γ-谷氨酰转移酶 病因 药物疗法

2017

胃肠病学
上海交通大学医学院附属仁济医院

胃肠病学

CSTPCD
影响因子:1.217
ISSN:1008-7125
年,卷(期):2017.22(7)
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