核苷(酸)类药物治疗CHB患者发生HCC的危险因素Logistic回归分析  

Logistic Regression Analysis of Risk Factors for Hepatocellular Carcinoma in Chronic Hepatitis b Patients Treated with Nucleos(t)ide Analogues

作　　者：朱姣姣[1] 王勤 王光霞 张毓珍 ZHU Jiaojiao;WANG Qin;WANG Guangxia(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052)

机构地区：[1]郑州大学第一附属医院,450052

出　　处：《实用癌症杂志》2021年第2期301-304,共4页The Practical Journal of Cancer

摘　　要：目的探讨核苷(酸)类药物治疗慢性乙型肝炎(CHB)患者发生原发性肝癌(HCC)的危险因素,为HCC防治提供参考。方法收集采用核苷(酸)类药物(NA)治疗的278例CHB患者临床资料,专人对患者资料进行回顾性的调查整理,对可能影响HCC发生的危险因素进行分析。结果278例患者中31例患者发生HCC,HCC发生率为11.15%。单因素分析显示性别、吸烟史、HBeAg表达状态、NA抗病毒治疗药物不同时HCC发生率比较差异无统计学意义(P>0.05),年龄、酗酒史、糖尿病史、HBV感染家族史、HCC家族史、HBV-DNA表达状态、肝硬化状态、抗病毒治疗时间不同时HCC发生率比较差异有统计学意义(P<0.05)。多因素Logistic回归分析患者年龄≥60岁、有HCC家族史、HBV-DNA阳性、肝硬化、抗病毒治疗时间<1年是患者发生HCC的独立危险因素(P<0.05)。结论年龄≥60岁、有HCC家族史、HBV-DNA阳性、肝硬化、抗病毒治疗时间<1年是NA治疗CHB患者发生HCC的主要危险因素,对有上述危险因素的CHB患者应积极进行抗病毒治疗并随访。Objective To investigate the risk factors for hepatocellular carcinoma(HCC)in chronic hepatitis b(CHB)patients treated with Nucleos(t)ide analogues(NA),provide reference for the prevention and treatment of HCC.Methods 278 cases of CHB patients treated with NA was selected,specially-assigned person was responsible for retrospective investigation and collation of patient data,risk factors that may influence the development of HCC were analyzed.Results 31 cases patients eventually developed HCC,the incidence of HCC was 11.15%.Single factor analysis showed no statistically significant differences in gender,smoking history,HBeAg expression status,and the incidence of HCC among patients with different antiviral drugs for NA(P>0.05),age,history of alcoholism,history of diabetes,family history of HBV infection,family history of HCC,hbv-dna expression status,cirrhosis status,and duration of antiviral treatment showed statistically significant differences in the incidence of HCC(P<0.05).Multivariate Logistic regression analysis:patients with age≥60 years,family history of HCC,positive hbv-dna,cirrhosis,and duration of antiviral treatment<1 year were independent risk factors for HCC(P<0.05).Conclusion Age≥60 years,family history of HCC,positive hbv-dna,cirrhosis,and antiviral therapy with NA<1 year were the main risk factors for HCC in patients treated with CHB,the types of NA antiviral drugs had no significant effect on the development of HCC,antiviral therapy and follow-up should be actively conducted for CHB patients with the above risk factors.

关 键 词：核苷(酸)类药物 慢性乙型肝炎 原发性肝癌 危险因素 LOGISTIC回归分析 

分 类 号：R735.7[医药卫生—肿瘤]