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肝硬化的定义、病因及流行病学
DOI: 10.3969/j.issn.1001-5256.2021.01.003
作者贡献声明：单姗负责撰写论文；赵连晖负责文献筛选和整理数据；马红、欧晓娟、尤红负责修改论文；贾继东负责拟定写作思路，指导撰写文章并最后定稿。
Definition, etiology, and epidemiology of liver cirrhosis
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摘要: 肝硬化是全球肝脏相关死亡的主要原因，最常见的原因是慢性乙型和丙型肝炎、酒精性肝病、非酒精性脂肪性肝病。近年研究显示，世界范围内，肝硬化死亡人数增加，但年龄标准化死亡率降低；失代偿期肝硬化的年龄标准化患病率显著增加。我国肝硬化患病人数、患病率、死亡人数和死亡率均有所增加，但是年龄标准化的患病率和死亡率均有所降低；主要病因仍为慢性乙型肝炎，但酒精性及非酒精性脂肪性肝病所致肝硬化比例也逐渐增加。Abstract: Liver cirrhosis is the leading cause of liver-related death globally, and the most common causes of liver cirrhosis are chronic hepatitis B and C, alcoholic liver disease, and nonalcoholic fatty liver disease. Recent studies have shown that despite an increase in the number of deaths due to liver cirrhosis around the world, there is a reduction in age-standardized death. In China, there are increases in number of patients with liver cirrhosis, prevalence rate of liver cirrhosis, number of deaths due to liver cirrhosis, and mortality rate of liver cirrhosis, while there are reductions in age-standardized prevalence rate and mortality rate; chronic hepatitis B remains the main cause of liver cirrhosis, with a gradual increase in the proportion of liver cirrhosis cases caused by alcoholic and nonalcoholic fatty liver diseases.
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Key words:
- Liver Cirrhosis /
- Etiology /
- Epidemiology
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表 1 肝硬化的病因
分类 具体病因 感染性 慢性病毒性肝炎(HBV、HCV)、寄生虫病(血吸虫病)等 化学损伤性 酒精性、药物性、毒物性肝病等 自身免疫性 自身免疫性肝炎、原发性胆汁性胆管炎、原发性硬化性胆管炎等 胆汁淤积性 先天性胆道闭锁，Allagile综合征，进行性家族性肝内胆汁淤积等 代谢性及遗传性 非酒精性脂肪性肝病、Wilson病、遗传性血色病、α1-抗胰蛋白酶缺乏症、糖原累积病、希川缺乏病等多种遗传代谢性肝病 血管性 肝外门静脉阻塞、肝窦阻塞综合征、Budd-Chiari综合征、右心血液回流障碍(右心衰竭、心肌病、缩窄性心包炎等)及遗传性出血性毛细血管扩张症等 
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