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希腊转诊三级中心主要慢性肝病的负担和近期流行病学变化。

The burden and recent epidemiological changes of the main chronic liver diseases in a Greek referral tertiary centre.

机构信息

Second Department of Internal Medicine, Athens University Medical School, Hipppokration General Hospital, Athens 115 27, Greece.

出版信息

Eur J Gastroenterol Hepatol. 2010 Feb;22(2):172-9. doi: 10.1097/MEG.0b013e328331115b.

Abstract

OBJECTIVE

To investigate the burden and recent epidemiological changes of the main chronic liver diseases in a Greek referral tertiary centre.

METHODS

We evaluated the main epidemiological characteristics of 1080 consecutive adult patients, seen at our outpatient liver clinic between 2002 and 2007, with chronic hepatitis B (HBV) and/or C (HCV) virus infection, alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD). Our patient population was divided into two groups in relation to the time of the first visit (period A: 2002-2004, period B: 2005-2007).

RESULTS

Among our patient population, 86.1% had chronic HBV and/or HCV infection (chronic HCV alone: 44.9%), 9.2% NAFLD and 4.8% ALD. From period A to B, there was a decrease in chronic HBV cases (44.0 vs. 37.8%, P = 0.045) with immigrants being responsible for 35.5% of them and being more frequent in period B than A (39.7 vs. 30.5%, P = 0.046). In chronic hepatitis B, hepatitis B e antigen-positive patients, who were more frequent immigrants compared with hepatitis B e antigen-negative patients (65.5 vs. 29.5%, P = 0.001), increased from period A to B (8.0 vs. 17.6%, P = 0.045). Intravenous drug use was reported by 41.2% of HCV patients with its proportion increasing from period A to B (32.5 vs. 47.4%, P = 0.002). Decompensated cirrhosis was present in 67, 10, 11 and 3% of patients with ALD, HBV, HCV and NAFLD, respectively.

CONCLUSION

At Greek tertiary centres, chronic viral hepatitis remains responsible for most chronic liver disease cases, but its epidemiology is changing owing to immigrants and intravenous drug users.

摘要

目的

研究希腊转诊三级中心主要慢性肝病的负担和近期流行病学变化。

方法

我们评估了 2002 年至 2007 年间在我们门诊肝脏诊所就诊的 1080 例连续成年患者的主要流行病学特征,这些患者患有慢性乙型肝炎(HBV)和/或丙型肝炎(HCV)病毒感染、酒精性肝病(ALD)或非酒精性脂肪性肝病(NAFLD)。根据首次就诊时间,我们将患者人群分为两组(时期 A:2002-2004 年,时期 B:2005-2007 年)。

结果

在我们的患者人群中,86.1%患有慢性 HBV 和/或 HCV 感染(单纯慢性 HCV:44.9%)、9.2%为 NAFLD 和 4.8%为 ALD。从时期 A 到时期 B,慢性 HBV 病例数减少(44.0%比 37.8%,P=0.045),移民占 35.5%,且在时期 B 比时期 A 更为常见(39.7%比 30.5%,P=0.046)。在慢性乙型肝炎中,与乙型肝炎 e 抗原阴性患者相比,乙型肝炎 e 抗原阳性患者更多为移民(65.5%比 29.5%,P=0.001),从时期 A 到时期 B 有所增加(8.0%比 17.6%,P=0.045)。41.2%的 HCV 患者有静脉吸毒史,其比例从时期 A 到时期 B 增加(32.5%比 47.4%,P=0.002)。ALD、HBV、HCV 和 NAFLD 患者分别有 6.7%、10%、11%和 3%为失代偿性肝硬化。

结论

在希腊的三级中心,慢性病毒性肝炎仍然是大多数慢性肝病病例的病因,但由于移民和静脉吸毒者的存在,其流行病学正在发生变化。

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