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作 者:韩聚强[1] 李国安[1] 郭汉斌[1] 熊锦华[1] 李亚松[1] 王帅[1] 龚丽娟[1] 曹建彪[1] 黄志刚[2]
机构地区:[1]北京军区总医院全军肝病中心,北京100700 [2]广东医学院公共卫生学院流行病与卫生统计学教研室,广东东莞523808
出 处:《中国医学前沿杂志(电子版)》2014年第3期27-30,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基 金:国家自然科学基金(30972594);王宝恩肝纤维化基金(2010-14)
摘 要:目的探讨原发性肝癌微创介入治疗术后乙型肝炎病毒(HBV)再激活的主要影响因素。方法收集50例HBV相关肝癌患者作为研究对象,以性别、年龄、抗病毒治疗、血常规、肝功能、肿瘤标志物甲胎蛋白(AFP)、微创治疗方法等作为研究因素,以是否引起HBV再激活作为因变量进行Logistic逐步回归分析。结果单因素分析显示,术前HBV DNA浓度、门脉癌栓、肿瘤大小、术前抗病毒治疗等均为影响因素(P<0.1)。经Logistic逐步回归分析提示,影响HBV再激活的影响因素涉及肿瘤大小、抗病毒治疗等,其中术前规范抗病毒治疗是保护因素,肿瘤直径>5 cm是HBV再激活的危险因素。结论 HBV相关原发性肝癌微创介入治疗后HBV再激活与肿瘤直径大小及是否术前抗病毒治疗等因素有关。肝癌肿瘤直径较大的患者,要重点监测并积极进行强效抗病毒治疗,以防HBV再激活。Objective To investigate the influence factors of HBV recurence after the micro-injuried interventional therapy of HBV-related hepatocellular carcinoma. Methods Fifty cases with HBV-related hepatocellular carcinoma(HCC) ware recruited in this study. The following informations were thought as exposed factors such as age, treatment, antiviral drugs, blood routine examination, liver function, tumor markers of AFP, and minimally invasive treatment. HBV reactivation was regarded as dependent variables in statistical analysis. Results Single factor analysis indicated that HBV loads before intervention therapy, tumor embolus, tumor size and antiviral therapy was contributed to HBV activation, respectively(P < 0.1). Mul-variable analysis of logistic regression showed both antiviral therapy and tumor size were the main variable influcing HBV reactiation after micro-injuried interventional treatment. Moreover, antiviral therapy was considered protective factor, and tumor'diameter of larger than 5 cm was a risk factor for HBV reactivation. Conclusion It is proved to HBV reactivation after micro-injuried interventional treatment of HBV-related hepatocellular carcinoma. Patients with large size HCC should be monitored as well as treated with anti-viral medicines in order to prevent HBV reactivation.
关 键 词:原发性肝癌 微创介入治疗 暴露因素 HBV再激活 LOGISTIC回归分析
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