摘要
目的:评估代偿期乙型肝炎肝硬化患者的生存情况,探讨其疾病进展的影响因素。方法:纳入2013年1月1日至12月31日就诊于上海中医药大学附属曙光医院、随访5年以上的代偿期乙型肝炎肝硬化患者609例,以截止2018年12月31日患者疾病进展(失代偿期、肝癌、死亡等)为终点事件,收集、整理患者5年随访期间一般资料及检验检查资料。应用寿命表法计算患者1年、3年、5年疾病无进展生存率;Kaplan-Meier法绘制生存曲线;Log-Rank检验进行单因素分析;COX模型进行多因素回归分析。结果:609例患者的平均疾病无进展生存时间63.00(95%CI=61.694~64.305)月;1年、3年、5年疾病无进展生存率为94%、83%、73%。对各可能存在的影响因素进行多因素回归分析显示,性别、年龄、抗病毒治疗、肝病家族史、Alb水平、PLT水平、HBV DNA、AFP水平为代偿期乙型肝炎肝硬化患者疾病进展的独立影响因素,其中女性、抗病毒治疗为保护因素,其余均为危险因素。结论:代偿期乙型肝炎肝硬化疾病进展与多因素有关,临床中应加强监测、及时治疗。
Objective:To evaluate the survival situation of patients with compensated hepatitis B cirrhosis and to explore the influencing factors of disease progression.Methods:A total of 609 patients with compensated hepatitis B cirrhosis,who were admitted to Shuguang Hospital from January 1 to December 31,2013 and were followed up for more than five years was included.Endpoints were estimated when disease progression happened,and the clinical data of patients during the five-year follow-up period were collected and collated.The life table method was used to calculated the disease progression-free survival time and one-year,three-year,five-year disease progression-free survival rates,and the survival curves were plotted by Kaplan-Meier method.Univariate analysis was performed with Log-Rank test,while COX model was used for multivariate regression analysis.Results:The average disease progression-free survival time of 609 patients was 63.00 months(95%CI=61.694-64.305),while one-year,three-year,five-year disease progression-free survival rates were 94%,83%,and 73%,respectively.Multivariate regression analysis of influencing factors showed that,gender,age,antiviral therapy,family history of liver disease,ALB level,PLT level,HBV DNA,AFP level were independent factors for disease progression,among which female and antiviral therapy were protective factors,and the rest were risk factors.Conclusion:The progression of compensated hepatitis B cirrhosis is related to multiple factors,so it is necessary to strengthen clinical monitoring and take treatment timely.
作者
陈博武
朱晓骏
黄凌鹰
孙学华
高月求
CHEN Bo-wu;ZHU Xiao-jun;HUANG Ling-ying(Department of Hepatopathy,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine(Shanghai,201203),China)
出处
《中西医结合肝病杂志》
CAS
2022年第7期584-587,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
国家自然科学基金(No.82074372、81774256)
上海市进一步加快中医药事业发展三年行动计划项目[No.ZY(2018-2020)-CCCX-2003-01]
重大疑难疾病中西医临床协作试点项目[No.ZY(2018-2020)-FXTW-2004]。
关键词
乙型肝炎肝硬化
代偿期肝硬化
疾病进展
hepatitis B cirrhosis
compensated liver cirrhosis
disease progression
factors
