老年乙肝患者肝硬化相关危险因素的评估  

Analysis of the risk factors of elderly patients with HBV-related hepatic cirrhosis

作　　者：成炳祥[1] 陈红花[1] 庄莉[2] 

机构地区：[1]浙江省绍兴第二医院肝胆胰外科,312000 [2]浙江大学附属第一医院肝胆外科,杭州市310006

出　　处：《中华全科医学》2014年第6期920-921,951,共3页Chinese Journal of General Practice

基　　金：浙江省卫生厅一般项目(201350072)

摘　　要：目的探讨影响老年乙肝患者肝硬化发生的相关危险因素,为老年乙肝患者肝硬化的防治提供理论依据。方法选择128例老年乙肝后肝硬化患者作为肝硬化组,96例老年乙肝患者作为对照组,采用酶联免疫吸附剂测定(enzyme linked immunosorbent assay,ELISA)和聚合酶链式反应(Polymerase Chain Reaction,PCR)分析比较2组的HBV相关的血清学指标、HCV RNA检测及乙肝病毒前C/C基因变异检测结果,采用Logistic回归进行老年乙肝后肝硬化危险因素的分析。结果老年乙肝后肝硬化组HBeAg(+)、抗-HBe(+)、HBV DNA、HVB和HCV重叠感染、乙肝病毒前C/C基因基因变异和饮酒史的检出率均显著高于对照组(P<0.05)。Logistic回归模型分析结果显示HBeAg(OR=1.415)、抗-HBe(OR=1.273)、HBV DNA(OR=1.628)、HVB和HCV重叠感染(OR=1.247)、乙肝病毒前C/C基因基因变异(OR=1.159)和饮酒史(OR=1.355)是老年乙肝患者肝硬化形成的主要危险因素。结论老年乙肝患者肝硬化的主要危险因素包括HBeAg、抗-HBe、HBV DNA、HCV重叠感染、乙肝病毒前C/C基因变异和饮酒史,在患者治疗过程中,应针对性地进行治疗和指导,使患者尽量减少由于这些因素的影响而导致的肝硬化。Objective To investigate the risk factors of elderly patients with HBV-related hepatic cirrhosis, so as to pro- vide the theoretical reference for the control of HBV-related hepatic cirrhosis. Methods We chose 128 elderly HBV-re- lated hepatic cirrhosis patients as hepatic cirrhosis group and 96 HBV patients as control group. Enzyme linked immu- nosorbent assay（ELISA） and Polymerase Chain Reaction（PCR） were used to analyze the serological indexes related to HBV, HCV RNA and Hepatitis B virus pre-C/C gene mutant. Logistic regression was used to analyze the risk factors of elderly patients with HBV-related hepatic cirrhosis. Results The risk factors had higher detection rate in hepatic cirrho- sis group than in control group（ P 〈 0.05 ）. Logistic multivariate regression analysis showed that HBeAg（ OR = 1. 415 ）, HBeAb （ OR = 1. 273 ）, HBV DNA （ OR = 1. 628 ）, overlapping infection by HBV and HCV （ OR = 1. 247 ）, Hepatitis B vi- rus pre-C/C gene mutant（ OR = 1. 159） and history of alcohol（ OR = 1. 355 ） were the major risk factors leading to HBV- related hepatic cirrhosis in elderly patients （P 〈 0.05 ）. Conclusion HBV patients should be instructed to avoid the im- pact of these factors in the process of treatment.

关 键 词：乙肝肝硬化 老年人 危险因素 

分 类 号：R512.62[医药卫生—内科学] R525.2[医药卫生—临床医学]