丙型肝炎病毒感染至肝硬化的影响因素分析

Factors that influence the progression from chronic hepatitis C virus infection to liver cirrhosis

目的探讨感染丙型肝炎病毒(HCV)的时间、感染途径、性别、肝功、HCVRNA、基因型、肝穿病理、治疗与否等因素对疾病发展至肝硬化的影响。方法351例丙型肝炎患者分为LC组和CHC组,对感染HCV至发展为肝硬化的各种可能影响因素进行统计学分析。结果LC组基线AST水平高于CHC组(t=2.015,P=0.045),LC组与CHC组ALT水平无显著差异(t=-1.158,P=0.248);LC组HCVRNA水平与CHC组HCVRNA水平无显著差异(t=0.718,P=0.473);基因型1b患者更易发展为肝硬化;感染HCV的时间越长,越容易发展为肝硬化(t=5.652,P<0.001);输血感染HCV的患者自感染HCV至发展为肝硬化所需时间较非输血感染者短(t=-4.439,P<0.001);LC组接受抗病毒治疗的患者比率明显低于CHC组(P<0.001);LC组与CHC组男女性别构成无差异(P=0.081)。结论感染HCV至发展为肝硬化受感染时间,感染途径,AST水平,病毒基因型、治疗与否等因素影响,与ALT水平、HCVRNA、性别关系不显著。

Objective To assess the influence factors such as transfusion, sex, AST, ALT, HCV RNA, HCV genotype,pathology, treat or not on the progression to cirrhosis in patients with chronic hepatitis C virus （HCV） infection. Methods Three hundred and fifty one HCV patients were divided into LC group and CHC group according to having liver cirrhosis or not. Results In LC group, the mean time of HCV in-fection was （ 16.0±8.2） years, while only （ 10.1±7.6） years for the patients in CHC group, and the difference was significant between them （ t = 5. 652, P 〈0.001 ）. The mean time for blood transfusion and non-transfusion patients to develop to cirrhosis were （ 13.0±4. 4） years and （20.9±10.3） years, respectively（t = -4. 439,P 〈0. 001 ）. The mean AST level for patients of LC group and CHC group were （90.9±57.6） U/L and （74.0± 64. 1 ） U/L, respectively, the difference between them was significant （t= 2. 015, P = 0. 045）. The mean ALT level for patients of LC group and CHC group were （106.9±94.8） U/L and （129.3±153.9） U/L, respectively, the difference between them was not significant （t=-1.158, P = 0.248）. The patients who had received anti-virus treatments are fewer in LC group than in CHC group, the difference between them was significant （ P 〈 0. 001 ）. Conclusions Our data show that HCV infection through blood transfusion can develop into liver cirrhosis in shorter time. ALT level has no significant correlation with liver fibrosis. HCV RNA titer and sex were found to have no influence on the progression to cirrhosis.