Das Anup K, Begum Tarjina, Kar Premashish, Dutta Anupam
Department of Medicine, Assam Medical College, Dibrugarh, Assam, India.
Department of Medicine, Maulana Azad Medical College New Delhi, India.
Euroasian J Hepatogastroenterol. 2016 Jul-Dec;6(2):111-115. doi: 10.5005/jp-journals-10018-1181. Epub 2016 Dec 1.
Acute liver failure (ALF) is a critical illness with a large number of viral and nonviral causes. Clinical course and etiologies in the Asian countries are different from those reported from the Western world and mortality is high. There may even be intracountry variations in large countries like India, which have differing culture, ethnicity, and environment. Data from North-east part of India is lacking.
Acute liver failure cases (>14 years of age) seen over a period of 8 years (n = 255) were studied at a Government Medical College in Assam for their etiological and other demographic profile. Viral serology was carried out and revalidated at a laboratory in New Delhi.
Majority of cases were <30 years of age. Commonest etiology was nonviral (non-ABCE). Amongst viral causes, hepatitis A and E were common, while hepatitis B virus (HBV) was rare. Unknown herbal medication use was very frequent in our cases with a significantly higher mortality. Mortality was highest in cases in 3rd decade of life. Statistically, international normalized ratio (INR) was the strongest predictor of death.
Unlike the rest of India, hepatitis virus is not the major cause of ALF in our part; hepatitis A being commoner than hepatitis E, and B is rare. Unknown herbal medications are major cause of mortality and is important medicosocial issue. Our study highlights the differences in the profile of ALF from other Indian and western studies, possibly due to sociocultural factors prevalent in this part.
Das AK, Begum T, Kar P, Dutta A. Profile of Acute Liver Failure from North-east India and Its Differences from other Parts of the Country. Euroasian J Hepato-Gastroenterol 2016;6(2):111-115.
急性肝衰竭（ALF）是一种由多种病毒和非病毒病因引起的危重病。亚洲国家的临床病程和病因与西方世界报道的不同，且死亡率很高。在像印度这样幅员辽阔、文化、种族和环境各异的国家，甚至可能存在国内差异。印度东北部地区的数据尚缺。
在阿萨姆邦的一所政府医学院，对8年间收治的255例急性肝衰竭病例（年龄>14岁）进行了病因及其他人口统计学特征研究。进行了病毒血清学检测，并在新德里的一家实验室进行了重新验证。
大多数病例年龄<30岁。最常见的病因是非病毒（非ABCE）病因。在病毒病因中，甲型和戊型肝炎常见，而乙型肝炎病毒（HBV）罕见。在我们的病例中，不明草药的使用非常频繁，且死亡率显著更高。第三年龄段的病例死亡率最高。从统计学上看，国际标准化比值（INR）是死亡的最强预测指标。
与印度其他地区不同，在我们这一地区，肝炎病毒不是急性肝衰竭的主要病因；甲型肝炎比戊型肝炎更常见，乙型肝炎罕见。不明草药是主要的死亡原因，是一个重要的医学社会问题。我们的研究突出了急性肝衰竭病例特征与其他印度及西方研究的差异，可能是由于该地区普遍存在的社会文化因素。
达斯AK、贝古姆T、卡尔P、杜塔A。印度东北部急性肝衰竭病例特征及其与该国其他地区的差异。《欧亚肝脏胃肠病学杂志》2016；6(2):111 - 115。
