Etiology of liver cirrhosis in Japan: a nationwide survey
Etiology of liver cirrhosis in Japan: a nationwide survey
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DOI：
10.1007/s00535-009-0128-5
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发表时间：
2010-01-01
影响因子：
6.3
通讯作者：
Onji, Morikazu
中科院分区：
文献类型：
--
作者：
Michitaka, Kojiro;Nishiguchi, Shuhei;Onji, Morikazu
关于肝硬化（LC）病因的流行病学分布的全球变化知之甚少。本研究通过全国范围的调查研究了日本肝硬化的病因，我们分析了58家医院33,379例LC患者的数据，并在第44届日本肝病学会年会计划中关于日本LC病因和临床特征的海报研讨会上发表了研究结果。我们确定了LC的病因分布，并将目前的结果与以前的日本研究结果进行比较，以估计LC病因变化的未来，其病因如下：B肝炎病毒（HBV）13.9%，丙型肝炎病毒（HCV）60.9%，酒精13.6%，原发性胆汁性肝硬化（PBC）2.4%和自身免疫性肝炎（AIH）1.9%。在2.1%的患者中，肝硬化被认为与非酒精性脂肪性肝炎（NASH）相关。有肝细胞癌（HCC）患者中HCV相关LC的比例显著高于无HCC患者（P < 0.0001），而酒精、PBC、AIH的比例则较低。肝细胞癌在31.5%的NASH相关的LC中是明显的。在日本肝硬化的主要病因仍然是HCV。我们的调查揭示了日本NASH相关LC的患病率和HCC的频率。在制定预防或教育策略以及开发新的治疗策略时，必须考虑病因学的未来变化。
Little is understood about worldwide changes in the epidemiological distribution of the etiology of liver cirrhosis (LC). The present study examines the etiology of liver cirrhosis in Japan using a nationwide survey.We analyzed data from 33,379 patients with LC at 58 hospitals and presented the findings in a poster symposium regarding the etiology and clinical features of LC in Japan that was included in the program of the 44th Annual Meeting of the Japan Society of Hepatology. We identified the distribution of the etiology of LC and compared the present with previous Japanese findings to estimate the future of etiological changes in LC.The etiological agents were as follows: hepatitis B virus (HBV) 13.9%, hepatitis C virus (HCV) 60.9%, alcohol 13.6%, primary biliary cirrhosis (PBC) 2.4% and autoimmune hepatitis (AIH) 1.9%. Cirrhosis was considered to be related to nonalcoholic steatohepatitis (NASH) in 2.1% of the patients. The ratio of HCV-related LC was significantly higher among patients with hepatocellular carcinoma (HCC) (P < 0.0001) compared to those without, whereas the ratios of alcohol, PBC, AIH were lower. HCC was evident in 31.5% of NASH-related LC.The major etiology of liver cirrhosis in Japan remains HCV. Our survey revealed the prevalence of NASH-related LC in Japan and the frequency of HCC. Future changes in etiology must be considered in establishing preventive or educational strategies, as well as in developing new treatment strategies.