乙肝肝硬化患者抗病毒治疗后肝癌发生的危险因素分析

目的:探讨乙肝肝硬化患者抗病毒治疗后仍然进展为肝细胞肝癌的危险因素。方法:纳入2014年7月至2017年7月我院收治的72例乙肝肝硬化患者的临床资料。根据乙肝肝硬化患者抗病毒治疗满1年后是否进展为肝细胞肝癌分为肝癌组(21例)和肝硬化组(51例)。收集两组患者临床资料，采用统计软件SPSS 21.0进行数据分析，将两组间差异有统计学意义的指标作为自变量，对自变量行Logistic单因素和多因素回归分析，探究乙肝肝硬化患者进展为肝细胞肝癌的独立危险因素。结果:对比两组患者的临床资料，发现性别、年龄、家族史、糖尿病史、谷草转氨酶(AST)及抗病毒治疗12周病毒学应答指标有差异，且差异具有统计学意义(P＜0.05)；对自变量行Logistic单因素和多因素回归分析，结果发现男性、年龄≥48岁和抗病毒治疗前AST≥40 U/L是乙肝肝硬化患者经抗病毒治疗后进展为肝细胞肝癌的独立危险因素(P＜0.05)。结论:男性、年龄大(≥48岁)和抗病毒治疗前AST≥40 U/L是乙肝肝硬化患者经抗病毒治疗后进展为肝细胞肝癌的独立危险因素。

Analysis of risk factors of hepatocellular carcinoma in patients with hepatitis B liver cirrhosis after antiviral treatment

Objective:To investigate the risk factors of hepatocellular carcinoma(HCC) in patients with hepatitis B liver cirrhosis after antiviral therapy.Methods:The clinical data of 72 patients with hepatitis B liver cirrhosis treated in our hospital from July 2014 to July 2017 were included.According to whether the patients with hepatitis B liver cirrhosis developed into hepatocellular carcinoma after one year of antiviral treatment,they were divided into liver cancer group(n=21) and liver cirrhosis group(n=51).Clinical data of two groups of patients were collected.The statistical significance of the difference between the two groups was used as the independent variable.Logistic univariate and multivariate regression analysis were performed to explore the independent risk factors for the progression of hepatocellular carcinoma in patients with hepatitis B liver cirrhosis.Results:By comparison of the clinical data of the two groups,it was found that there were significant differences in gender,age,family history,diabetes history,AST and virological response index between the two groups at 12 weeks after antiviral treatment(P<0.05).The independent variables were analyzed by Logistic univariate and multivariate regression analysis.The results showed that male,age≥48 years old and AST≥40 U/L before antiviral treatment were independent risk factors for progress of liver cirrhosis B into hepatocellular carcinoma after antiviral treatment(P<0.05).Conclusion:Male,age≥48 years old and AST≥40 U/L before antiviral treatment were independent risk factors for progress of liver cirrhosis B into hepatocellular carcinoma after antiviral treatment.