Clinical Analysis Of Hospitalized Cases With Intrahepatic Cholestasis Disease

ObjectiveThe aim of this study was to analyse the causes,clinical features and laboratory tests of 770 adults with intrahepatic cholestasis disease.MethodsWe included inpatients with the first time happened with intrahepatic cholestasis disease in Nanjing Drum Tower Hospital between January 2010 and December 2014.All patients had a list of ALP equal or greater than 1.5 ULN and GGT equal or greater than 3 ULN.Then,eliminated the extrahepatic biliary obstruction according to the CT,MRI or abdominal ultrasound ect.and ruled out the patients under the age of eighteen as well,people who had Biliary tract operation also excluded.There were 935 patients with intrahepatic cholestasis disease,and 165 patients with incomplete datas,finally,770 patients involved in the research.Recorded the clinical diagonses,clinical datas Analysed the construction of disease that cause intrahepatic cholestasis disease,the clinical and laboratory features.Results1.The diseases that caused intrahepatic cholestasis were quite complicated and various,the most pathogenys of intrahepatic cholestasis in our study were digestive system tumors(18.57%),cardiovascular diseases(10.91%),blood system diseases(7.40%),virus or bacterial infection(5.97%),and systemic autoimmune diseases(3.90%),shock(3.12%),Drug-induced liver damage(2.86%),PBC(2.73%),liver cirrhosis(2.21%),ICP(1.95%),preeclampsia(1.17%),chemical toxicosis(1.17%),non-alcohlic fatty liver disease(0.78%),AIH(0.78%)and so on.Totally speaking,intrahepatic cholestasis involved in every clinical section,cardiovascular diseases,digestive system tumors,blood system diseases,infection,metabolic disorders and autoimmune diseases were the main causes of the intrahepatic cholestasis.The digestive system tumors was more likely occurred in males,while PBC,ICP,systemic autoimmune diseases,preeclampsia,chemical toxicosis trended to females.2.Divided the patients into groups according to the different etiology,analyzed the clinical manifestation of groups with people equal or greater than 6.These diseases had more clinical apperances:non-alcohlic fatty liver disease,Drug-induced liver damage and PBC.3.There were 24.02%patients with jaundice,the percentage of mild,moderate and severe jaundice were 21.30%、2.21%、0.52%.With the emergence of jaundice,compared with non-jaundice,ALT,AST,ALP,GGT,DB,TB,DB/TB,TBA in Jaundice groups increased.ALT,AST,DB,TB,TBA,DB/TB were statistical differences among non-jaundice,mild jaundice,moderate jaundice,acute jaundice(P<0.05),however,ALP,GGT were similar among four groups(P>0.05),and there were no differences in ages and sexs.4.The main causes of intrahepatic cholestasis disease with mild jaundice were digestive system tumors,cardiovascular diseases,blood system diseases,infection and PBC.The main causes of moderate jaundice group were digestive system tumors and blood diseases,the causes of acute jaundice group were liver cancer,PBC,shock,paraquat poisoning.Conclusions1.There are many diseases can cause a intrahepatic cholestasis in adult people,still many uncommon causes can be seen in this reserch.2.There is a gender difference in some diseases3.The clinical manifestations of intrahepatic cholestasis are various,some patients may not have a typical apperance.4.As for intrahepatic cholestasis disease,the aminotransferases were increased with the rising of bilirubin,we should be careful about the damages of hepatocytes...