肝细粒棘球蚴病手术患者病灶活性状态的影响因素分析  

Analysis of the influencing factors of lesion activity in hepatic cystic echinococcosis patients

作　　者：侯娇 温浩 王明坤 蒋铁民 房彬彬 李静[2] 张传山 王慧[1,2] HOU Jiao;WEN Hao;WANG Ming-kun;JIANG Tie-min;FANG Bin-bin;LI Jing;ZHANG Chuan-shan;WANG Hui(State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia,Clinical Medicine Institute,Xinjiang Key Laboratory of Echinococcosis,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Basic Medical College,Xinjiang Medical University,Urumqi 830054,China;Department of Hepatobiliary&Hydatid Diseases,Digestive&Vascular Surgery Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]省部共建中亚高发病成因与防治国家重点实验室,新疆医科大学第一附属医院,临床医学研究院,乌鲁木齐830054 [2]新疆医科大学基础医学院,乌鲁木齐830054 [3]新疆医科大学第一附属医院消化血管外科中心肝胆包虫外科,乌鲁木齐830054

出　　处：《中国寄生虫学与寄生虫病杂志》2022年第3期309-315,共7页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：新疆维吾尔自治区重点实验室开放课题(2019D04021);新疆维吾尔自治区天山青年计划“杰出青年科技人才”项目(2020Q007);国家自然科学基金(81860359,82160397);省部共建中亚高发病成因与防治国家重点实验室开放课题项目(SKL-HIDCA-2020-5)。

摘　　要：目的 明确影响肝细粒棘球蚴病患者病灶活性状态的主要因素,为提高细粒棘球蚴病的诊疗效果提供决策依据。方法收集2018年1月至2020年6月在新疆医科大学第一附属医院行手术治疗的251例肝细粒棘球蚴病患者的人口学信息和临床相关资料,应用影像学技术,并结合其生物学特性将病灶CE1、 CE2、 CE3分为活性组,病灶CE4、 CE5分为无活性组,以病灶有无活性为因变量进行单因素分析,根据单因素分析结果,构建非条件logistic回归模型,分析影响病灶活性状态的独立影响因素。使用SPSS 26.0统计软件进行统计学分析。结果本研究符合纳入标准的251例肝细粒棘球蚴病手术患者中,女性占57.0%(143例),高于男性的43.0%(108例);年龄为4~85岁,平均年龄为(41.31±15.05)岁;患者文化程度偏低,高中及以下文化程度占79.3%(199例);居住乡村占比为66.9%(168例),高于居住城市的33.1%(83例);汉族占42.2%(106例),其他少数名族占57.8%(145例);初发占比为78.1%(196例),高于复发的21.9%(55例);有活性病灶占比为76.9%(193例),高于无活性病灶的23.1%(58例)。单因素分析结果显示,不同年龄、民族、有无复发、病灶数、病灶大小以及血液检查指标红细胞、凝血酶原时间、直接胆红素和碱性磷酸酶与肝细粒棘球蚴病患者的病灶活性状态差异有统计学意义(χ^(2)=17.110、 7.797、 2.906、 4.702、 16.520,Z=-1.989、 2.446、 2.003、1.914;P <0.1)。非条件logistic回归结果显示,影响肝细粒棘球蚴病患者病灶活性状态的主要因素为年龄和病灶大小,年龄越小、病灶越大其病灶活性占比越高(P <0.05)。结论 通过对251例肝细粒棘球蚴病手术患者的临床资料分析显示,年龄越小和病灶越大是影响肝细粒棘球蚴病患者病灶活性状态的独立影响因素。Objective To identify the main factors affecting the active state of lesions in patients with hepatic cystic echinococcosis and provide the basis for decision-making to improve the diagnosis and treatment of cystic echinococcosis.Methods A total of 251 patients with hepatic cystic echinococcosis receiving surgical treatment at the First Affiliated Hospital of Xinjiang Medical University from between January 2018 and June 2020 were enrolled,and their demographic information and clinical data were collected,Based on the imaging and biological characteristics,the cysts classified as CE1,CE2 and CE3 were grouped as active group,and CE4 and CE5 inactive group.Using the cyst activity as the dependent variable,univariate analysis was performed,based on which unconditinal logistic regression model was constructed to analyze the independent factors influencing the cyst activity status.Results In this study,clinical data of 251 patients with hepatic cystic echinococcosis meeting the inclusion criteria were collected,with 57.0%(143 cases) female and 43.0%(108 cases) male.The age of the patients ranged from4 to 85 years old,and the average age was (41.31±15.05) years old.Most of the patients had a low educational level,with high school or below accounting for 79.3%(199 cases);the rural resident accounted for 66.9%(168cases),which is higher than that of the urban resident 33.1%(83 cases).The percentage of CE in Han nationality was 42.2%(106 cases),while that in other minority nationalities was 57.8%(145 cases).The percentage of patients w ith their first infection was 78.1%(196 cases),which is higher than that of the recurrent infection (21.9%,55 cases).The active lesions accounted for 76.9%(193 cases),and the inactive lesions accounted for 23.1%(58 cases).The results of the univariate analysis showed that there were significant differences among patients with different age groups,ethnic groups,the active state of lesions between patients with hepatic cystic echinococcosis and those without recurrence,the number of lesions,t

关 键 词：细粒棘球蚴病 临床特征 病灶活性 影响因素 

分 类 号：R532.32[医药卫生—内科学]