启东地区中老年HBV慢性感染人群合并脂肪肝的关联因素分析  

An analysis of fatty liver and related factors of middle-aged and elderly people from a HBV infec tion cohort in Qidong area

作　　者：余钦 张永辉[3] 朱健[3] 陈永胜[3] 翟东霞 陆建华[3] 孙燕[3] 陆玲玲[3] 丁璐璐[3] 姜小平[3] 凌昌全 陈建国[5] YU Qin;ZHANG Yonghui;ZHU Jian;CHEN Yong-sheng;ZHAI Dong-xia;LU Jian-hua;SUN Yan;LU Ling-ling;DING Lu-lu;JIANG Xiao-ping;LING Chang-quan;CHEN Jian-guo(Second Oncology Department,Shanghai University of Traditional Chinese Medicine,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200437,China;Graduate School,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Qidong Liver Cancer Institute/Qidong People’s Hospital/Qidong Hospital,Nantong University,Qidong 226200,China;Department of Traditional Chinese Medicine,Changhai Hospital,the Second Military Medical University,Shanghai 200433 China;Epidemiology Research Office,Nantong Uni versity Tumor Hospital/Institute,Nantong 226231,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院肿瘤二科,上海200437 [2]上海中医药大学研究生院,上海201203 [3]启东肝癌防治研究所/启东市人民医院/南通大学启东医院,启东226200 [4]海军军医大学附属长海医院中医系,上海200433 [5]南通大学附属肿瘤医院/研究所流行病学研究室,南通226231

出　　处：《中华疾病控制杂志》2020年第9期1032-1036,1078,共6页Chinese Journal of Disease Control & Prevention

基　　金：国家科技重大专项课题(2018ZX10732-202-001-004);国家自然科学基金面上项目(81573653);国家科学技术支撑计划课题(2012BA141B05)。

摘　　要：目的探讨乙型肝炎病毒(hepatitis B virus,HBV)慢性感染合并脂肪肝的关联因素,为HBV合并脂肪肝的防治提供依据.方法选择2019年6月启东市HBV感染队列随访人群,收集相关病史信息,采用B超检测脂肪肝,用多因素Logistic回归分析模型分析合并脂肪肝的关联因素.结果该队列人群年龄(63.22±7.84)岁,脂肪肝患病率为30.18%(909/3012);患病率女性高于男性(33.94%>27.25%,χ^2=15.767,P<0.001).患病率在各年龄组差异有统计学意义(χ^2=11.614,P=0.003),以60~70岁年龄组最高.肝纤维化患者中脂肪肝的检出率为62.50%(205/328).多因素Logistic回归分析模型分析显示,高血压、糖尿病、高血脂病史、烟酒嗜好以及肥胖是脂肪肝的主要危险因素(均有P<0.001).结论启东地区中老年HBV感染人群脂肪肝的患病率较高,且女性高于男性,并随年龄增长而降低.体重、血压、血脂及肝纤维化等也是脂肪肝不可忽视的危险因素,应当加以重视.Objective To investigate the related factors of chronic hepatitis B virus(HBV)infection with fatty liver disease(FLD),in order to provide a basis for prevention and treatment.Methods The HBV infection cohort in Qidong City was followed up in June 2019 to collect relevant medical history information.FLD was detected by B-ultrasound and the related factors were analyzed by multivariate Logistic regression model.Results The age of the cohort was(63.22±7.84)years old,and the prevalence of FLD was 30.18%(909/3012).The prevalance rate of FLD was higher in female than in male(33.94%>27.25%,χ^2=15.767,P<0.001),and with statistical difference among age groups(χ^2=11.614,P=0.003),being the highest in the 60-70 age group.The detection rate of fatty liver in pa-tieuts with hepatic fibrosis was 62.50%(205/328).Multivariate Logistic regression analysis showed that history of hypertension,diabetes,hyperlipidemia,as well as tobacco or alcohol preferences and obesity were main risk factors for FLD(all P<0.001).Conclusions The FLD prevalence of the middle-aged and elderly individuals in the HBV-infected cohort in Qidong is high,especially in women and 60-70 age group.Body weight,blood pressure,blood lipid and liver fibrosis are also the risk factors of FLD,which should be paid attention to.

关 键 词：乙型肝炎 脂肪肝 因素分析 患病率 

分 类 号：R181.1[医药卫生—流行病学]