Etiology and mode of presentation of chronic liver diseases in India: A multi centric study
Etiology and mode of presentation of chronic liver diseases in India: A multi centric study
复制标题
DOI：
10.1371/journal.pone.0187033
复制
发表时间：
2017-10-26
期刊：
影响因子：
3.7
通讯作者：
Chowdhury, Abhijit
中科院分区：
文献类型：
--
作者：
Mukherjee, Partha S.;Vishnubhatla, Sreenivas;Chowdhury, Abhijit
印度缺乏慢性肝病的卫生政策相关数据，阻碍了制定干预策略来解决这个问题。本文报道了一项旨在描述印度慢性肝病病因和临床特征的前瞻性多中心研究。开发并分析了一个集中协调和监测的网络数据储存库（2010年2月至2013年1月）。来自印度不同地区的11家医院参加了会议。数据被上传到一个基于网络的形式，并由一个单一的中心根据标准化协议进行监测。在印度11家参与医院就诊的所有患者（n = 20701383）中，1.28%（n = 266621）患有肝病。65807例（24.68%）为首次确诊（新发病例）。其中，最终分析了13014例（19.77%，中位年龄43岁，73%为男性）慢性肝病病例。失代偿期肝硬化占33.9%。酒精中毒（34.3%）是肝硬化的最常见原因，而B型肝炎（33.3%）是一般慢性肝病和非酒精性慢性肝病（40.8%）的主要原因。慢性肝病的主要病因存在显著的区域间差异（北方为丙型肝炎，东部和南部为B型肝炎，东北部为酒精，西部为非酒精性脂肪性肝病）。B型肝炎（46.8%）是肝癌的最常见病因。11.7%患有糖尿病。我们研究的观察结果将有助于指导印度与背景相关的肝脏护理政策，并可以作为其他发展中国家类似奋进的框架。
There is a paucity of health policy relevant data for chronic liver disease from India, impeding formulation of an interventional strategy to address the issue. A prospective, multicentric study to delineate the etiology and clinical profile of chronic liver disease in India is reported here. A centrally coordinated and monitored web-based data repository was developed (Feb, 2010 to Jan, 2013) and analyzed. Eleven hospitals from different parts of India participated. Data were uploaded into a web based proforma and monitored by a single centre according to a standardized protocol. 1.28% (n = 266621) of all patients (n = 20701383) attending the eleven participating hospitals of India had liver disease. 65807 (24.68%) were diagnosed for the first time (new cases). Of these, 13014 (19.77%, median age 43 years, 73% males) cases of chronic liver disease were finally analyzed. 33.9% presented with decompensated cirrhosis. Alcoholism (34.3% of 4413) was the commonest cause of cirrhosis while Hepatitis B (33.3%) was predominant cause of chronic liver disease in general and noncirrhotic chronic liver disease (40.8% out of 8163). There was significant interregional differences (hepatitis C in North, hepatitis B in East and South, alcohol in North-east, Non-alcoholic Fatty Liver Disease in West) in the predominant cause of chronic liver disease. Hepatitis B (46.8% of 438 cases) was the commonest cause of hepatocellular Cancer. 11.7% had diabetes. Observations of our study will help guide a contextually relevant liver care policy for India and could serve as a framework for similar endeavor in other developing countries as well.