Bellentani S, Tiribelli C, Saccoccio G, Sodde M, Fratti N, De Martin C, Cristianini G
Centro Studi fegato, Fondo per lo Studio delle Malattie del Fegato, Italy.
Hepatology. 1994 Dec;20(6):1442-9. doi: 10.1002/hep.1840200611.
Data on the prevalence of chronic liver disease, derived from selected series of hospitalized patients or from mortality registers, underestimate the prevalence of chronic liver disease. The Dionysos Study is a cohort study that investigated for the first time the prevalence of chronic liver disease in a general population. All the citizens of two towns in northern Italy, Campogalliano and Cormons, aged 12 to 65 yr were contacted by letter. From March 1991 through March 1993, 6,917 of a total of 10,150 citizens were enrolled (compliance, 69%). The standardized protocol for each enrollee included (a) a color-illustrated food questionnaire on dietary habits and alcohol intake; (b) a detailed medical history, including questions on risk factors for chronic liver disease; (c) a physical examination; and (d) blood tests for AST, ALT, gamma-glutamyltranspeptidase, mean cell volume, platelet count and hepatitis B virus and hepatitis C virus markers. Signs suggestive of chronic liver disease were seen in 21.3% of the subjects, and who then underwent further liver function tests, upper abdominal ultrasonography and, when necessary, liver biopsy. Persistent signs of chronic liver disease were present in 17.5% of the subjects, including 1.1% with cirrhosis and 0.07% with hepatocellular carcinoma. The prevalence rates of hepatitis B virus and hepatitis C virus positivity (second-generation enzyme-linked immunosorbent assay) were 1.3% and 3.2%, respectively. Alcohol abuse was the etiological agent in 23%.(ABSTRACT TRUNCATED AT 250 WORDS)
源自特定住院患者系列或死亡率登记数据的慢性肝病患病率低估了慢性肝病的实际患病率。狄俄尼索斯研究是一项队列研究,首次调查了普通人群中慢性肝病的患病率。通过信件联系了意大利北部坎波加利亚诺和科尔蒙斯两个城镇所有年龄在12至65岁的公民。从1991年3月到1993年3月,在总共10150名公民中有6917人登记入组(依从率69%)。每位入组者的标准化方案包括:(a)一份关于饮食习惯和酒精摄入量的彩色插图食物问卷;(b)详细的病史,包括有关慢性肝病危险因素的问题;(c)体格检查;(d)检测谷草转氨酶、谷丙转氨酶、γ-谷氨酰转肽酶、平均红细胞体积、血小板计数以及乙肝病毒和丙肝病毒标志物的血液检查。21.3%的受试者出现了提示慢性肝病的体征,随后这些人接受了进一步的肝功能检查、上腹部超声检查,必要时还进行了肝活检。17.5%的受试者存在慢性肝病的持续体征,其中1.1%为肝硬化,0.07%为肝细胞癌。乙肝病毒和丙肝病毒阳性率(第二代酶联免疫吸附试验)分别为1.3%和3.2%。23%的病因是酒精滥用。(摘要截选于250词)