乙型肝炎病毒感染与结直肠腺瘤的相关性研究

目的 探讨乙型肝炎病毒（HBV）感染对结直肠腺瘤发生发展的影响。方法 选取2016年1月~2018年1月于我院接受筛查或诊断性结肠镜检查符合入组标准的506例患者进行回顾性病历对照研究。按照乙肝五项定量结果分为非HBV感染组及HBV感染组，感染组人员依据HBV-DNA结果进一步分为HBV-DNA阳性组与HBV-DNA阴性组，比较乙型肝炎病毒感染不同状态与非感染者腺瘤发生率之间的差异及HBV活动对腺瘤发生部位，大小等的影响。结果 ①HBV感染组和非HBV感染组在年龄、性别、吸烟史、饮酒史、高血压史、糖尿病史、胆囊切除史、药物服用史等方面比较，差异均无统计学意义（P＞0.05）；②HBV-DNA阳性组腺瘤发病率高于非HBV感染组（37.10% vs 24.16%）差异有统计学意义（P＜0.05）；③HBV-DNA阳性组远端结肠腺瘤性息肉、腺瘤数目≥2个的发病率高于非HBV感染组（24.19% vs 12.47%），差异均有统计学意义（P＜0.05），HBV-DNA阳性组进展期腺瘤、＞10 mm及近端结肠腺瘤性息肉腺瘤发病率高于非HBV感染组，但差异无无统计学意义（P＞0.05）。结论 HBV感染患者远端结肠腺瘤发病率升高且全肠段易多发腺瘤，对于各类型慢性乙型肝炎患者或反复乙型肝炎再活动者应采取与普通人不同的结直肠腺瘤筛查及预防策略。

Correlation between Hepatitis B Virus Infection and Colorectal Adenoma

Objective To investigate the effect of hepatitis B virus (HBV) infection on the development of colorectal adenoma.Methods A retrospective medical history study was performed on 506 patients who underwent screening or diagnostic colonoscopy in our hospital from January 2016 to January 2018. According to the five quantitative results of hepatitis B, the patients were divided into non-HBV infection group and HBV infection group. The infection group was further divided into HBV-DNA positive group and HBV-DNA negative group according to HBV-DNA results, comparing different states of hepatitis B virus infection. The difference between the incidence of adenomas in infected patients and the influence of HBV activity on the location and size of adenomas. Results ①There were no significant differences in age, gender, smoking history, drinking history, history of hypertension, history of diabetes, history of cholecystectomy, and history of drug use between the 1HBV-infected group and the non-HBV-infected group (P>0.05);②The incidence of adenoma in HBV-DNA positive group was higher than that in non-HBV infection group (37.10% vs 24.16%)the difference was statistically significant (P<0.05);③The incidence of distal colon adenomatous polyps and adenomas ≥2 in HBV-DNA positive group was higher than that in non-HBV infection group (24.19% vs 12.47%), the difference was statistically significant (P<0.05),The incidence of advanced adenoma, >10 mm and proximal colon adenomatous polyposis in HBV-DNA positive group was higher than that in non-HBV infection group, but the difference was not statistically significant (P>0.05). Conclusion Patients with HBV infection have an increased incidence of distal colon adenomas and multiple adenomas in the entire intestine. For patients with various types of chronic hepatitis B or repeated hepatitis B re-activity, screening for colorectal adenomas should be performed differently from ordinary people and prevention strategies.