Serviço de Gastroenterologia, Hospital Universitário Cassiano A Moraes, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
Clinics (Sao Paulo). 2013;68(3):291-5. doi: 10.6061/clinics/2013(03)oa02.
To report the etiology of liver cirrhosis cases diagnosed at the University Hospital in Vitoria, Espirito Santo, Brazil.
The medical charts of patients with liver cirrhosis who presented to the University Hospital in Vitoria were reviewed. Chronic alcoholism and the presence of hepatitis B or C infections (HBV and HCV, respectively) were pursued in all cases.
The sample consisted of 1,516 cases (male:female ratio 3.5:1, aged 53.2 ± 12.6 years). The following main etiological factors were observed: chronic alcoholism alone (39.7%), chronic alcoholism in association with HBV or HCV (16.1 %), HCV alone (14.5%) and in association with alcoholism (8.6%) (total, 23.1 %), and HBV alone (13.1%) and in association with alcoholism (7.5%, total 20.6%). The remaining etiologies included cryptogenic cases (9.8%) and other causes (6.0%). The mean patient age was lower and the male-to-female ratio was higher in the cirrhosis cases that were associated with alcoholism or HBV compared with other causes. Intravenous drug abuse and a history of surgery or blood transfusion were significantly associated with HCV infection. Hepatocellular carcinoma was present at the time of diagnosis in 15.4% of cases. Chronic alcoholism associated with HCV infection was significantly associated (p<0.001) with reduced age (at the time of cirrhosis diagnosis) and increased prevalence of hepatocellular carcinoma (p = 0.052).
Alcoholism, HCV and HBV are the main factors associated with liver cirrhosis in the state of Espirito Santo. Chronic alcoholism associated with HCV infection reduced the age of patients at the time of liver cirrhosis diagnosis.
报告巴西圣埃斯皮里图州维多利亚大学医院诊断的肝硬化病例的病因。
回顾了所有在维多利亚大学医院就诊的肝硬化患者的病历。所有病例均追查慢性酒精中毒和乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）感染的情况。
该样本包括 1516 例患者（男：女比例为 3.5:1，年龄为 53.2±12.6 岁）。观察到以下主要病因：单纯慢性酒精中毒（39.7%）、慢性酒精中毒合并 HBV 或 HCV（16.1%）、HCV 单独感染（14.5%）和合并酒精中毒（8.6%）（共计 23.1%）以及 HBV 单独感染（13.1%）和合并酒精中毒（7.5%）（共计 20.6%）。其余病因包括隐源性病例（9.8%）和其他病因（6.0%）。与其他病因相比，与酒精或 HBV 相关的肝硬化病例的平均患者年龄更低，男女比例更高。静脉药物滥用和手术或输血史与 HCV 感染显著相关。诊断时，15.4%的病例存在肝细胞癌。慢性酒精中毒合并 HCV 感染与年龄（肝硬化诊断时）降低和肝细胞癌患病率增加显著相关（p<0.001）（p=0.052）。
在圣埃斯皮里图州，酒精中毒、HCV 和 HBV 是导致肝硬化的主要因素。慢性酒精中毒合并 HCV 感染降低了肝硬化诊断时患者的年龄。
