Comparison Of Clinical Characteristics Of Patients Between Viral Cirrhosis And Alcoholic Cirrhosis: A Retrospective Analysis

Objective:We compared and analyzed the variances of clinical features, complications and prognosis between patients with viral cirrhosis and those with alcoholic cirrhosis. It is aimed to explore the different tendency of treatment for the two diseases.Methods:952 admission data of patients with cirrhosis in the First Affiliated Hospital of Dalian Medical University, form April 2004 to May 2009, of which 656 cases of viral cirrhosis (VC),198 patients of alcoholic cirrhosis (AC) and 98 cases of mixed above two etiologies cases (AC+VC) were collected. Sex, age, history, manifestations, liver function, complica-tions, and the direct death cause were compared.ResultsOf all cases, VC occupied the main part (63.66%), and more than a half of the total was hepatitis B cirrhosis. AC was at the second place (19.17%), and that in mixed etiologies was 9.50%. There was no significant difference among the three groups of the average duration. Compared to VC, the AC had younger age and was commonly seen in male patients (P<0.05).The prevalence of splenomegaly, spider nevus and hepatic face in clinical manifestations showed statistical difference among the three groups. Facial telangiectasia and spider nevus presented obviously in group AC,and the incidence of splenomegaly and dull complexion enhanced in VC group compared to that in AC group, with statistical difference (P<0.05).Upper gastrointestinal bleeding was the most common complication in all the groups. In VC and AC+VC group, the top three incidences of compli-cations respectively were upper gastrointestinal bleeding, hepatocellular carcinoma and hepatic encephalopathy. The prevalence of hepatic encepha-lopathy was higher than hepatocellular carcinoma in AC group and the most common complications were upper gastrointestinal bleeding, hepatic encephalopathy and hepatocellular carcinoma orderly in this group. However, there were not statistical differences in the prevalence of upper gastrointestinal bleeding, hepatic encephalopathy and hepatorenal syndrome among the three groups (P>0.05).The prevalence of hepatocellular carcinoma in VC group were higher than AC group (P<0.01), moreover, the combined etiologies could lead to much higher prevalence (30.6%).The occurrence of spontaneous bacterial peritonitis in AC group was more than in VC group (P<0.01).The hepatic encephalopathy was the common direct death cause in both VC and AC group and the following causes were upper gastrointestinal bleeding and hepatocellular carcinoma. In AC+VC group, hepatocellular carcinoma was the main death cause, and the next causes were hepatic encephalopathy, upper gastrointestinal bleeding and hepatorenal syndrome.Conclusions1. The most common complication was upper gastrointestinal bleeding and the most common death cause was hepatic encephalopathy in either viral cirrhosis or alcoholic cirrhosis. Hepatocellular carcinoma was the most common direct death cause in combined etiologies group.2. Compared to viral cirrhosis, the occurrence of spontaneous bacterial peritonitis was much more than that in alcoholic cirrhosis.3. Complications were the main important variance among the three groups, which guided us to give different tendency of prophylaxis and treatment so as to reduce the morbidity.