Rong Yi-hui, You Shao-li, Liu Hong-ling, Zhu Bing, Zang Hong, Zhao Jing-min, Li Bao-sen, Xin Shao-jie
Chinese PLA Postgraduate Medical School, Beijing 100853, China.
Zhonghua Gan Zang Bing Za Zhi. 2012 Apr;20(4):300-3. doi: 10.3760/cma.j.issn.1007-3418.2012.04.015.
To investigate the etiology, pathology, and clinical characteristics of cryptogenic liver diseases in order to develop a pathogenic profile for clinical diagnosis and therapeutic design.
The data of the 566 patients diagnosed with abnormal liver function and who had undergone liver biopsy at our institute between January 2006 to March 2010 were retrospectively analyzed. The Chi-squared (x²) test was used to assess disease correlation with sex and the rank sum test was used to assess disease correlation with continuous data since all data had asymmetric distribution.
Among the 566 patients, abnormal liver function was attributed to alcoholic liver disease (n=175; 30.92%), drug-induced or environmentally-induced liver disease (n=101; 17.84%), hereditary and metabolic disease (n=93; 16.43%), infectious hepatitis disease (n=84; 14.84%), fatty liver disease (n=53; 9.36%), and autoimmune liver disease (n=30; 53.00%). Thirty patients had unknown etiology, despite liver biopsy analysis. Among these disease subgroups, there were distinct correlations with sex, age, and levels of alanine transaminase (ALT) and gamma-glutamyltransferase (GGT). The autoimmune liver disease group was correlated with sex (q=9.14, 7.435, 5.071, 9.529, and 12.5, respectively; P less than or equal to 0.01). The alcoholic liver disease group and autoimmune liver disease group were correlated with age (vs. genetic metabolic disease group: q=17.254 and 10.302; infectious hepatitis group: q=17.523 and 10.697); drug/environmentally-induced liver damage group: q=9.170 and 5.266); fatty liver group: q=7.118 and 4.661) (P less than or equal to 0.01). In addition, the alcoholic and autoimmune liver disease groups were correlated with GGT levels (vs. genetic metabolic disease group: q=8.003; infectious hepatitis group: q=4.793; drug/environmentally-induced liver damage group: q=4.404) (P less than or equal to 0.01).
Liver pathology is important for the diagnosis of cryptogenic liver diseases. Patient age, sex, and biochemistry index may facilitate diagnosis and treatment in the absence of pathology.
研究不明原因肝病的病因、病理及临床特征，以建立有助于临床诊断和治疗设计的致病谱。
回顾性分析2006年1月至2010年3月间在我院诊断为肝功能异常并接受肝活检的566例患者的数据。由于所有数据均呈非对称分布，采用卡方（x²）检验评估疾病与性别的相关性，采用秩和检验评估疾病与连续数据的相关性。
在566例患者中，肝功能异常归因于酒精性肝病（n = 175；30.92%）、药物性或环境性肝病（n = 101；17.84%）、遗传性和代谢性疾病（n = 93；16.43%）、传染性肝炎疾病（n = 84；14.84%）、脂肪性肝病（n = 53；9.36%）和自身免疫性肝病（n = 30；5.30%）。尽管进行了肝活检分析，但仍有30例患者病因不明。在这些疾病亚组中，与性别、年龄以及丙氨酸转氨酶（ALT）和γ-谷氨酰转移酶（GGT）水平存在明显相关性。自身免疫性肝病组与性别相关（q分别为9.14、7.435、5.071、9.529和12.5；P≤0.01）。酒精性肝病组和自身免疫性肝病组与年龄相关（与遗传代谢性疾病组相比：q =17.254和10.302；与传染性肝炎组相比：q =17.523和10.697；与药物/环境性肝损伤组相比：q =9.170和5.266；与脂肪性肝病组相比：q =7.118和4.661）（P≤0.01）。此外，酒精性和自身免疫性肝病组与GGT水平相关（与遗传代谢性疾病组相比：q =8.003；与传染性肝炎组相比：q =4.793；与药物/环境性肝损伤组相比：q =4.404）（P≤0.01）。
肝脏病理对于不明原因肝病的诊断很重要。在缺乏病理结果时，患者的年龄、性别和生化指标可能有助于诊断和治疗。
