论文部分内容阅读
目的:通过分析新疆地区隐源性肝硬化患者的临床特征,探讨在乙型肝炎病毒(hepatitis B virus)高流行区域隐源性肝硬化的可能病因.方法:回顾性分析2001-01/2009-01新疆医科大学第一附属医院241例符合隐源性肝硬化诊断标准的住院肝硬化病例资料,其中包括隐源性肝硬化患者222例,隐源性肝硬化伴原发性肝细胞癌患者19例,对其性别、年龄、民族、合并高血压、糖尿病等代谢伴发情况进行研究分析.结果:4023例肝硬化患者中有241例符合隐源性肝硬化的诊断标准,占据总体肝硬化患者的5.99%,在241例患者中有98例(40.66%)合并糖尿病,55例合并高血压(22.82%),其中222例为单纯隐源性肝硬化(平均年龄54.86岁±16.09岁,44%为男性),隐源性肝硬合并肝癌的患者共19例,肝癌的发生率为7.88%(平均年龄67.42岁±7.03岁,47%为男性),其中隐源性肝硬化组和隐源性肝硬化合并肝癌组的糖尿病发病率分别为40%和57%,高血压发病率分别为20%和58%.单因素分析结果显示,单纯隐源性肝硬化和隐源性肝硬化合并肝癌患者在年龄和高血压方面有显著性差异(t=-6.47,P<0.001)和(t=13.8,P<0.001),收缩压和舒张压在两组中也有显著性差异(t=-3.63,P<0.001)和(t=-3.42,P<0.001),多因素回归分析显示年龄、高血压是隐源性肝硬化发展为肝癌的独立危险因素(OR=1.086,95%CI:1.03-1.14,P<0.001;OR=5.4,95%CI:2.05-14.23,P<0.001).结论:我们的研究显示,本组隐源性肝硬化合并较高的2型糖尿病和高血压代谢综合征指征,符合非酒精性脂肪肝病的临床特征,提示作为HBV较高流行的新疆地区隐源性肝硬化与非酒精脂肪性肝病具有相关的可能性大.
Objective: To explore the possible etiopathogenesis of cryptogenic cirrhosis in the endemic area of hepatitis B virus by analyzing the clinical characteristics of patients with cryptogenic cirrhosis in Xinjiang.Methods: The clinical data of 2001-01 / 2009- 01 The First Affiliated Hospital of Xinjiang Medical University, 241 cases of cryptogenic liver cirrhosis meet the diagnostic criteria of hospitalized cirrhosis cases, including 222 patients with cryptogenic cirrhosis, cryptogenic cirrhosis with primary hepatocellular carcinoma in patients 19 Cases of gender, age, ethnicity, hypertension, diabetes mellitus and other metabolic conditions were analyzed.Results: 241 cases of 4023 cases of cirrhosis meet the diagnostic criteria of cryptogenic cirrhosis, accounting for the total number of patients with cirrhosis Of the 241 patients, 98 (40.66%) had diabetes mellitus and 55 had hypertension (22.82%), of which 222 were simple cryptogenic cirrhosis (mean age 54.86 ± 16.09, 44% Male), 19 cases of cryptogenic cirrhosis with liver cancer, the incidence of liver cancer was 7.88% (mean age 67.42 years ± 7.03 years, 47% male), of which cryptogenic cirrhosis group and cryptogenic The incidence of diabetes in patients with cirrhosis and hepatocellular carcinoma was 4 0% and 57% respectively, and the incidence of hypertension was 20% and 58%, respectively.Univariate analysis showed that there were significant differences in age and hypertension between simple cryptogenic cirrhosis and cryptogenic cirrhosis with hepatocellular carcinoma systolic blood pressure and diastolic blood pressure were also significantly different between the two groups (t = -3.63, P <0.001) and (t = -3.42, (OR = 1.086,95% CI: 1.03-1.14, P <0.001; OR = 5.4,95%, P <0.001) .Multivariate regression analysis showed that age and hypertension were independent risk factors for developing HCC from cryptogenic cirrhosis CI: 2.05-14.23, P <0.001) .CONCLUSIONS: Our study shows that this group of patients with cryptogenic cirrhosis with higher type 2 diabetes mellitus and metabolic syndrome of hypertension is consistent with the clinical features of non-alcoholic fatty liver disease , Suggesting that as a high prevalence of HBV in Xinjiang, cryptogenic cirrhosis and non-alcoholic fatty liver disease are associated with the possibility of large.