Objective: To investigate the etiology, prevention and treatment status, and their corresponding regional differences of the patients with liver cirrhosis in China, in order to provide scientific basis for the development of diagnosis and control strategies in China. Methods: Clinical data of patients diagnosed with liver cirrhosis for the first time through January 1, 2018 to December 31, 2020 from 50 hospitals in seven different regions of China were collected and analyzed retrospectively, and the difference of etiology, treatment, and their differences in various regions were analyzed. Results: A total of 11 861 cases with liver cirrhosis were included in the study. Thereinto, 5 093 cases (42.94%) were diagnosed as compensated cirrhosis, and 6 768 cases (57.06%) had decompensated cirrhosis. Notably, 8 439 cases (71.15%) were determined as chronic hepatitis B-caused cirrhosis, 1 337 cases (11.27%) were alcoholic liver disease, 963 cases (8.12%) were chronic hepatitis C, 698 cases (5.88%) were autoimmune liver disease, 367 cases (3.09%) were schistosomiasis, 177 cases (1.49%) were nonalcoholic fatty liver, and 743 cases (6.26%) of other types of liver disease. There were significant differences in the incidence of chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, fatty liver, schistosomiasis liver disease, and autoimmune liver disease among the seven regions (P<0.001). Only 1 139 cases (9.60%) underwent endoscopic therapy, thereinto, 718 cases (6.05%) underwent surgical therapy, and 456 cases (3.84%) underwent interventional therapy treatment. In patients with compensated liver cirrhosis, 60 cases (0.51%) underwent non-selective β receptor blockers(NSBB), including 59 cases (0.50%) underwent propranolol and 1 case (0.01%) underwent carvedilol treatment. In patients with decompensated liver cirrhosis, 310 cases (2.61%) underwent NSBB treatment, including 303 cases (2.55%) underwent propranolol treatment and 7 cases (0.06%) underwent carvedilol treatment. Interestingly, there were significant differences in receiving endoscopic therapy, interventional therapy, NSBB therapy, splenectomy and other surgical treatments among the seven regions (P<0.001). Conclusion: Currently, chronic hepatitis B is the main cause (71.15%) of liver cirrhosis in several regions of China, and alcoholic liver disease has become the second cause (11.27%) of liver cirrhosis in China. The three-level prevention and control of cirrhosis in China should be further strengthened.
目的： 调查我国肝硬化患者的病因、防治现状、地区差异，为我国肝硬化的诊疗措施制定和防治水平提高提供科学依据。 方法： 本项横断面研究分析了2018年1月1日至2020年12月31日我国七大地理分区的50家医院首次住院诊断为肝硬化的患者临床资料，分析患者病因构成、治疗方案及其在不同区域的差异。 结果： 区域分布方面，研究共纳入11 861例肝硬化患者。疾病严重程度方面，代偿期患者5 093例（42.94%），失代偿期患者6 768例（57.06%）。病因方面，慢性乙型肝炎8 439例（71.15%）、酒精性肝病1 337例（11.27%）、慢性丙型肝炎963例（8.12%）、自身免疫性肝病698例（5.88%）、血吸虫性肝病367例（3.09%）、非酒精性脂肪性肝病177例（1.49%）以及其他类型肝病743例（6.26%）。病因分布差异方面，慢性乙型肝炎、慢性丙型肝炎、酒精性肝病、非酒精性脂肪性肝病、血吸虫性肝病、自身免疫性肝病的区域分布差异均有统计学意义（P<0.001）。手术治疗方面，1 139例（9.60%）患者接受了内镜治疗，718例（6.05%）接受了外科治疗，456例（3.84%）接受了介入治疗。内科治疗方面，在代偿期患者中，有60例（0.51%）接受了非选择性β受体阻滞剂（NSBB）治疗，其中接受普萘洛尔治疗59例（0.50%）、接受卡维地洛治疗1例（0.01%）；在失代偿期患者中，有310例（2.61%）接受了NSBB治疗，其中接受普萘洛尔治疗303例（2.55%）、接受卡维地洛治疗7例（0.06%）。内外科治疗的区域差异方面，不同地区患者接受内镜治疗、介入治疗、NSBB治疗等的差异有统计学意义（P<0.001）。 结论： 我国现阶段大部分地区肝硬化病因仍以慢性乙型肝炎为主，酒精性肝病成为第二大病因。肝硬化的三级防控在我国仍待加强。.