隐源性肝硬化患者发生肝细胞肝癌的危险因素探讨

Risk Factors for the Occurrence of Hepatocellular Carcinoma in Patients With Cryptogenic Cirrhosis

目的分析隐源性肝硬化(CC)患者发生肝细胞肝癌(HCC)的危险因素。方法回顾性收集新疆医科大学第一附属医院2009年7月—2014年7月符合纳入与排除标准的CC患者241例。按照诊断结果将患者分为单纯CC组(222例)和CC合并HCC组(19例)。收集并比较患者性别、年龄、民族、体质量、是否合并高血压、是否合并糖尿病、恶性肿瘤家族史、药物过敏史、Child-Pugh评分、血红蛋白、平均红细胞体积、球蛋白、三酰甘油、总胆固醇、尿酸、肌酐、尿蛋白等指标。结果单因素条件Logistic回归分析结果显示,年龄、是否合并高血压、尿蛋白是CC患者发生HCC的影响因素(P<0.05)。多因素非条件Logistic逐步回归分析结果显示,以α=0.05为显著水准,进入回归模型的变量有年龄、合并高血压(P<0.05)。结论高血压和年龄高是CC患者发生HCC的危险因素,应对CC患者血压升高及年龄予以重视,正确评估,以降低其发生HCC的风险。

Objective To investigate the risk factors for the occurrence of hepatocellular carcinoma（ HCC）in patients with cryptogenic cirrhosis（ CC） . Methods 241 CC patients who accorded with the inclusion and exclusion criteria from the First Teaching Hospital of Xinjiang Medical University between July 2009 and July 2014 were enrolled in the study. According to the results of diagnoses,the subjects were divided into two groups：CC group（n =222）and CC ＋HCC group（n =19）. Comparison was made between the two groups in gender, age, ethnic group, body mass, whether complicated with hypertension,whether complicated with diabetes mellitus,family history of malignant tumor,drug allergy history,Child-Pugh score, hemoglobin, mean corpuscular volume, globulin, triacylglycerol, total cholesterol, uric acid, creatinine and urine protein. Results Univariate conditional Logistic regression analysis showed that age,urine protein and whether complicated with hypertension were influencing factors for HCC in CC patients（ P 〈0. 05 ） . Multivariate non - conditional Logistic stepwise regression analysis showed that,with α=0. 05 as the outstanding standard,the variables that entered regression model included age and being complicated with hypertension（P〈0. 05）. Conclusion Age and hypertention are risk factors for HCC in patients with CC. The elevation of blood pressure and age should be paid special attention and evaluated correctly,in order to reduce the risk of HCC in CC patients.