An etiological analysis of liver diseases with negative hepatotropic virus / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the etiology of liver diseases with negative hepatotropic virus, and to provide ideas for the clinical diagnosis and treatment of liver diseases. MethodsA retrospective analysis was performed for the clinical data and liver biopsy results of 113 patients with negative hepatotropic virus who were admitted to The Affiliated Hospital of Xuzhou Medical University from July 2018 to December 2019. According to sex, they were divided into male group with 41 patients and female group with 72 patients, and according to age, they were divided into youth group with 42 patients, middle-aged group with 56 patients, and elderly group with 15 patients. The chi-square test was used for comparison of categorical data between groups. ResultsAmong the 113 patients with negative hepatotropic virus, 111(98.23%) were given a confirmed diagnosis, among whom 43 (38.05%) were diagnosed with nonalcoholic fatty liver disease (NAFLD), 40(35.40%) were diagnosed with drug-induced liver injury (DILI), 16(14.15%) had autoimmune liver disease (AILD), 8(7.08%) had alcoholic liver disease, 3(2.65%) had biliary disease, and 1(0.88%) had diseases in other systems which involved the liver. Among the male patients, 53.49% had NAFLD, 100% had ALD, and 15% had DILI, while among the female patients, 85% had DILI, 46.51% had NAFLD, and 93.75% had AILD. For DILI, there were significantly more female patients than male patients (χ2=40000, P＜0.001), and for AILD, there were also significantly more female patients than male patients (χ2=12.250, P＜0.001). In the youth group, NAFLD (55.81%), DILI (20%), and ALD (75%) were the main causes of disease, and DILI was the main cause in the middle-aged group and the elderly group. Among the patients with NAFLD, there were significantly more patients in the youth group than in the elderly group (χ2=16.333, P＜0.001); among the patients with DILI, there were significantly more patients in the middle-aged group than in the youth group (χ2=8.000, P=0.005); among the patients with AILD, there were significantly more patients in the middle-aged group than in the youth group (χ2=8.333, P=0.004). ConclusionMost liver diseases with negative hepatotropic virus can be diagnosed by liver biopsy, and NAFLD, DILI, and AILD are the main causes. Patients with different sexes and ages have different etiologies.