Etiological And Complication Analysis Of Liver Cirrhosis Of2002Cases

Objective:To identify the etiologies and associated complication of livercirrhosis for new cases over past decade in the Second Affiliated ClinicalCollege of Chongqing University of Medical Sciences.Methods:The inpatient medical record database was searched for allindividuals admitted with a new diagnosis of liver cirrhosis betweenJanuary2002and December2011. Data on demographics and clinicalfindings were collected for retrospective analysis to determine the regionaland temporal profiles of etiologies and complications.The countdata,expressed as percent of total,was analyzed by the Chi-squared test.Results:1. Among the total2002liver cirrhosis cases, the most frequentetiologies was viral hepatitis type B(60.6%), fatty liver caused by bothhepatitis B virus (HBV) and alcohol (16.6%), alcoholic fatty liver (6.6%),autoimmune liver disease (6.7%), and nonalcoholic fatty liver(1.7%). 2. From the first half of decade to the second half(January2002-December2006vs. January2002-December2011),the incidences oftwo etiologies significantly increased(HBV and alcohol:13.6%vs17.7%,P <0.05and autoimmune liver disease:3.5%vs.7.1%, P <0.05) and theincidence of HBV significantly decreased(64.1%to59.3%, P <0.05).3. Among the total1213HBV cases, there were229(18.0%) caseswho had been treated with anti-viral drugs before admission. From the firsthalf of decade to the second half(January2002-December2006vs. January2002-December2011),the incidence of antiviral therapy increased (13.0%to21.3%, P <0.01).4. The most common major complication of cirrhosis were livercancer (22.1%), spontaneous peritonitis(21.3%), upper gastrointestinalbleeding (19.3%), hepatic encephalopathy (7.3%), and hepatorenalsyndrome(4.0%).5. The incidence of liver cancer was significantly higher in patientswiths a family history of hepatitis(31.3%vs.22.2%, p<0.05), positivelycorrelated with HBV DNA load(χ2=10.88， P <0.05) and antiviral therapy(χ2=4.04, P <0.05).For the cirrhosis caused by both HBV and alcohol,theincidence of liver cancer and upper gastrointestinal bleeding were33.1%and34.9%respectively. Conclusions:It is suggested that hepatitis B virus still the major cause of cirrhosis.Two factors(hepatitis B virus and alcoho1) and autoimmune liver diseasereveals a tendency of increase. liver cancer is the main complication in livercirrhosis, correlated with family history, HBV DNA load, alcohol andantiviral therapy. the cirrhosis caused by both hepatitis B virus andalcoho1has the worst prognosis.