Clinical Analysis Of 140 Cases Of Alcoholic Liver Disease

Alcoholic liver disease (ALD) is a kind of damaged pathologicalchanges in liver that is caused by a great quantity of alchol. Frompathologic diagnosis it including pristine ALD, alcoholic fatty liver(AFL), alcoholic hepatitiss (AH), alcholic hepatic fibrosis andalcoholic cirrhosis. These five types develop alone or simultaneously.ALD is concerned with the time of drinking wine,the quantity ofalchol and variety of wine.The more the quantity of alchol and thetime of drinking wine, the more liver have been damaged. Mixed winealso can aggravate the damage of liver. The factors that cause ALD isdefined, but its pathogenesy is very complicated. The diseaseincidence of ALD in our country have the tendency of increasing.Especially the quantity of adolescent who is addicted to drinking isincreasing continuely. The study have retrospectively analysized for140 cases of ALD to approach the clinical future and imageologycharacteristic of ALD, and to provid new ment for clinical diagnosisand differential diagnosis. 1. Materials and methods 1.1 Patients 140 perfect in-patient cases with were collected to study. Allpatients with AFL and AH were diagnosed by ultrasonography at the1st clinical hospital affiliated JiLin University from January 2000 toNovember 2005. The median age was 48.48 years(range:27～86years)and 10 patients were female. These patients include 40 cases of AFLand 100 cases of AH. 200 check-up people which were not in ALDwere shlected as controls. The median age was 49.75 years(range:18～85years) and 46 patients were female.1.2 Criteria of group140 perfect in-patient case were separated into two groups: AFLgroup and AH group according to the diagnostic criteria that draftedby Chinese Medical Association for the study of ALD in conferenceheld in Nanjing October 2002. Diabetes mellitus and hyperlipemiawere diagnosed according to the diagnostic criteria that published atthe textbook of Internal Medicine (6th edition). The width of portalvein and the size of spleen were meased by Siemens Elegrd colorDoppler.1.3 Statistical analysisResult were expressd as Mean±Standard Deviation or thenumber (percentage) of patients with each variable. The X2-test orT-test was used to compare each group. P<0.05 hint the significantdifference, and P<0.01 hint the difference is very significant.2. Result2.1 the age distribution future of the groups of AFL and AHThe patients in the group of AFL include 2 case whose age lessthan 30yr, 8 cases whose age in the range between 30yr and 40yr, 10cases whose age in the range between 81yr and 50yr, 4 cases whoseage in the range between 51yr and 60yr, and 8 cases whose ageexceed 60yr. The patients in the group of AH include 1 case whoseage less than 30yr, 26cases whose age in the range between 30yr and40yr, 40 cases whose age in the range between 81yr and 50yr, 24cases whose age in the range between 51yr and 60yr, and 8 caseswhose age exceed 60yr. From above-mentioned data, there were mostpatients who were belonged to 40-60yr population. Among twogroups, the age distribution showed no significant difference.2.2 Blood glucose and blood fatIn this study, 26 patients complicating diabetes mellitus (18.57%),including 10 cases of AFL (38.46%) and 16 cases of AH (61.54%). 58patients complicating hyperlipemia (41.43%). In these cases 44patients have hyper-triglyeride (75.86%), including 16 cases of AFL(36.36%) and 28 cases of AH (63.63%). 14 patients havehyper-cholesterol (24.13%), including 6 cases of AFL (42.86%) and 8cases of AH (57.12%). The rate of hyper-triglyeride exceed the rate ofhyper-cholesterol.2.3 Hepatic functionIn this study, 94 patients had abnormal aminopherase (67.14%),including 20 cases of AFL (14.18%) and 74 cases of AH (52.86%). 74patients had increased ALT (78.72%), including 16 cases of AFL(17.02%) and 58 cases of AH (61.70%). 86 patients had increasedAST (91.49%), including 10 cases of AFL (10.64%) and 76 cases ofAH (80.85%). 114 patients had increased GGT (81.43%), including20 cases of AFL (17.54%) and 94 cases of AH (82.46%).The AST, ALT and GGT of the patients with ALD were morethan normal people significantly, especially in GGT. Among thegroups of AH and AFL, the level of AST, ALT and GGT showedsignificant difference (P<0.01).2.4 imageologyIn this study, 28 patients had portal width that exceed 13mm(20%), including 2 cases of AFL (7.14%) and 26 cases of AH(92.86%);56 patients had spleen which thickness exceed 40mm(40%), including 30 cases of AFL (89.28%) and 26 cases of AH(10.72%).2.5 Clinical manifestationThe clinical manifestation of ALD have no specificity. In thestudy, 124 patient had fatigue (88.57%), including 20 cases of AFLand 102 cases of AH. 110 patient had decreased food appetite(78.57%), including 10 cases of AFL and 100 cases of AH.104 patienthad abdominal distention (74.28%), including 10 cases of AFL and 94cases of AH. 20 patient had ache in hepatic region (14.28%),including 16 cases of AFL and 4 cases of AH. 24 patient had resistedoiliness (17.14%), including 8 cases of AFL and 16 cases of AH. 10patient had fever (7.14%), who all was AH. 30 patient had nausea(21.42%), who all was AH. 6 patient had diarrhea (4.28%), who allwas AH. 56 patient had jaundice (40%), including 8 cases of AFL and48 cases of AH. 44 patient had liver palm (31.42%), including 4 casesof AFL and 40 cases of AH. 24 patient had spider telangiectasia(17.14%), including 1 cases of AFL and 23 cases of AH. 136 patienthad hepatomegaly (97.14%), including 100 cases of AFL and 36 casesof AH.In the group of AFL, fatigue, ache in hepatic region,hepatomegaly were seen most frequently. In the group of AH,decreased food appetite, abdominal distention, fever, nausea, diarrheaand jaundice were seen most frequently.3. Conclusion3.1. The peak age at diagnosis of alcoholic fatty liver andalcoholic hepatitis range from 30 to 60yr. The majority of thesepatients include laborers, leaders in organization and businessmen,who drink wine more impossiblely.3.2. Alcoholic liver disease is usually complicating diabetesmellitus and hyperlipemia, and especially level of triglyerideincreasing mostly.3.3. AST and ALT increase slightly in the group of alcoholicfatty liver. AST and ALT increase significant in the group of alcoholichepatitis. Most patients have increased GGT.3.4. The portal width of the patients with alcoholic fatty liver andalcoholic hepatitis exceed normal people, and the thickness of spleenexceed normal.3.5. The patients with alcoholic fatty liver have slight symptomor no symptom, fatigue, ache in hepatic region, hepatomegaly wereseen most frequently. The patients with alcoholic hepatitis havesignificant symptom, and decreased food appetite, abdominaldistention, fever, nausea, diarrhea and jaundice were seen mostfrequently.