马来西亚的肝硬化：一个多民族亚洲国家的独特流行病学。

Liver cirrhosis in Malaysia: peculiar epidemiology in a multiracial Asian country.

机构信息

Division of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

J Gastroenterol Hepatol. 2011 Aug;26(8):1333-7. doi: 10.1111/j.1440-1746.2011.06732.x.

DOI:10.1111/j.1440-1746.2011.06732.x

PMID:21443669

Abstract

BACKGROUND AND AIM

To determine the etiology of liver cirrhosis and risk factors for hepatocellular carcinoma (HCC) in a multiracial Asian population.

METHODS

Consecutive patients with liver cirrhosis presenting to outpatient clinics and inpatient service at the University of Malaya Medical Centre from 1 April 2006 to 31 May 2009 were included.

RESULTS

A total of 460 patients were included in the study: 317 male patients (68.9%) and 143 female patients (31.1%), with a mean age of 58.8years (range: 15-87years). The major causes of cirrhosis were: chronic hepatitis B, n=212, 46.1%; chronic hepatitis C, n=85, 18.5%; cryptogenic, n=71, 15.4%; alcohol, n=58, 12.6% and autoimmune, n=9, 2.0%. Alcohol was the main etiology in Indians (51.1%) compared to Malay (0%) and Chinese (4.4%) (both P<0.001). Hepatitis B was the predominant etiology in Malay (47.9%) and Chinese (58.8%) compared to Indians (5.6%) (both P<0.001). Hepatitis C cirrhosis was highest in Malays (25.0%). 136 patients (29.6%) had concurrent HCC. Male sex (P<0.001), age>60years (P=0.014), hepatitis B (P<0.001), hepatitis C (P=0.006) and cryptogenic cause (P=0.002) were found to be independent risk factors for HCC.

CONCLUSIONS

The etiology of cirrhosis has a peculiar pattern based on racial differences in alcohol intake and in the prevalence of hepatitis B.

摘要

背景与目的

在一个多民族的亚洲人群中，确定肝硬化的病因学及肝细胞癌（HCC）的危险因素。

方法

连续纳入 2006 年 4 月 1 日至 2009 年 5 月 31 日期间在马来亚大学医学中心门诊和住院部就诊的肝硬化患者。

结果

本研究共纳入 460 例患者：男性 317 例（68.9%），女性 143 例（31.1%），平均年龄 58.8 岁（15-87 岁）。肝硬化的主要病因是：慢性乙型肝炎 212 例（46.1%），慢性丙型肝炎 85 例（18.5%），原因不明 71 例（15.4%），酒精性 58 例（12.6%），自身免疫性 9 例（2.0%）。与马来人和中国人（均为 0%）相比，酒精是印度人（51.1%）的主要病因（均 P<0.001）。乙型肝炎是马来人（47.9%）和中国人（58.8%）的主要病因，而印度人（5.6%）则较少见（均 P<0.001）。丙型肝炎肝硬化在马来人中最高（25.0%）。136 例（29.6%）患者合并 HCC。男性（P<0.001）、年龄>60 岁（P=0.014）、乙型肝炎（P<0.001）、丙型肝炎（P=0.006）和原因不明（P=0.002）是 HCC 的独立危险因素。