慢性丙型肝炎病毒感染患者临床转归的影响因素分析

Analysis on influencing factors for clinical outcomes of patients with chronic hepatitis C virus infections

目的分析慢性丙型肝炎病毒(HCV)感染患者临床转归的影响因素,为HCV感染患者的预后提供参考。方法选取医院2007年5月-2013年4月医院收治的HCV感染患者156例,根据患者临床症状、生化指标和影像学检查将患者分为慢性丙型肝炎组(CHC)96例和肝硬化组(LC)60例;对比两组患者的宿主因素、病毒因素和治疗情况并分析,采用SPSS19.0进行统计分析。结果 CHC组中接受抗病毒治疗的患者比例较LC组更高,CHC组患者伴有代谢综合征(MS)危险因子患者比例显著高于LC组,IL-28B基因型rs12979860CT/TT、rs8099917TG/GG以及HCV基因型,两组比较差异有统计学意义(P<0.05);同时,多因素分析与LC相关因素发现,患者感染年龄、抗病毒治疗、MS危险因子和rs12979860、rs8099917基因型是影响LC的因素。结论 CHC转化为LC与患者感染年龄、是否接受抗菌药物治疗、MS危险因子和rs12979860、rs8099917基因型直接关联,这对往后临床预测慢性HCV感染患者的转归具有指导价值。

OBJECTIVE To analyze influencing factors for clinical outcomes of patients with chronic hepatitis C virus（HCV）infections,and provide reference for the prognosis of patients with HCV infections.METHODS A total of156 patients with HCV infections admitted in this hospital from May 2007 to Apr.2013 were selected and divided into the chronic hepatitis C（CHC）group of 96 patients and the liver cirrhosis（LC）group of 60 patients according to clinical symptoms,biochemical indexes and imageological examination.The two groups of patients were compared for host factors,viral factors and treatment.The analysis was performed with SPSS 19.0software.RESULTS The proportion of patients who received antiretroviral therapy and who had risk factors for metabolic syndrome（MS）was higher in the CHC group than in the LC group.For IL-28 Bgenotype rs12979860CT/TT,rs8099917TG/GG and HCV genotype,the difference between the two group was significant（P0.05）.Meanwhile,multivariate analysis of factors associated with LC found that infection age,antiretroviral therapy,MS risk factors and rs12979860,rs8099917 genotypes were the LC influencing factors.CONCLUSION The conversion of CHC into LC was directly related to infection age,antiretroviral therapy,MS risk factors and rs12979860,rs8099917 genotypes.This conclusion can provide guidance for the follow-up prediction of clinical outcomes of patients with chronic HCV infections.