乙型肝炎病毒感染与慢性胰腺炎发病风险的关系

Association between hepatitis B virus infection and the incidence risk of chronic pancreatitis

目的 探讨乙型肝炎病毒（HBV）既往感染与慢性胰腺炎（CP）发病风险的关系.方法 收集2015年1月至2016年10月第二军医大学长海医院消化内科诊治的CP患者571例,应用流行病学病例对照研究方法,以年龄、性别等相匹配的同期1216例健康体检者为对照组,检测研究对象血清HBV的5项标志物 （HBsAg、HBsAb、HBeAg、HBeAb和HBcAb）,分析各标志物与CP发病的相关性.结果 HBsAg阳性率在CP组和对照组分别为3.0%和3.8%,OR=0.039,95%CI0.02~0.80,差异有统计学意义（P〈0.000）,但在HBsAg阳性的所有HBV标志物（HBVM）模式中,CP组和对照组差异无统计学意义;HBsAb阳性率在CP组和对照组分别为51.8%和75.0%,差异有统计学意义（P〈0.000）;HBeAg阳性率在CP组和对照组分别为1.1%和0.1%,差异有统计学意义（P〈0.05）,但在HBeAg阳性的HBVM模式组中,CP组和对照组差异无统计学意义;HBeAb阳性率在CP组和对照组分别为24.3%和10.8%,差异有统计学意义（P〈0.00）;HBcAb阳性率在CP组和对照组分别为50.1%和16.5%,差异有统计学意义（P〈0.000）.在HBsAb＋ ＋HBeAb＋ ＋HBcAb＋、HBsAb＋ ＋HBcAb＋、HBeAb＋ ＋HBcAb＋、HBcAb＋ 4种模式中,CP组阳性率均显著高于对照组,差异有统计学意义（P〈0.000）.多因素回归分析显示,HBsAb＋、HBeAb＋是胰腺炎的保护因素（P〈0.05）,而HBcAb＋是胰腺炎的独立危险因素（OR=6.931,P〈0.000）.结论 HBsAb＋和HBeAb＋是CP的保护因素,而HBcAb＋可看作是CP的独立危险因素.

Objective To investigate the correlation of previous hepatitis B virus （HBV） infection with the incidence risk of chronic pancreatitis （CP）.Methods This was a case control study.Five hundred and seventy-one patients with CP admitted in the Department of Gastroenterology, Changhai Hospital, Second Military Medical University between January 2015 and October 2016 were enrolled, and 1216 sex and age matched health individuals were also enrolled as the control group.The 5 serum HBV markers（HBsAg,HBsAb, HBeAg, HBeAb and HBcAb） were detected and their correlation with CP incidence was analyzed.Results The positive rate of HBsAg in the CP group and the control group were 3.0% and 3.8%, respectively, and the difference was statistical significant.（OR=0.039, 95% CI 0.02~0.80, P〈0.00）, but in all the HBsAg positive models （HBVM） the difference of CP and control groups was not statistical significant.HBsAb positive rate in CP group and the control group were 51.8% and 75.0%, respectively, and the difference was statistical significant（P〈0.000）.HBeAg positive rate in CP group and the control group were 1.1% and 0.1%, the difference was statistical significant （P〈0.05）, but in all the HBeAg positive models, the CP group and the control group had no statistical difference （P〉0.05）.The positive rate of HBeAb in the CP group and the control group were 24.3% and 10.8%, respectively, and the difference was statistical significant（P〈0.00）.The positive rate of HBcAb in the CP group and the control group were 50.1% and 16.5%, respectively,and the difference was statistical significant（P〈0.000）.In the（HBsAb＋, HBeAb＋, HBcAb＋）, （HBsAb＋, HBcAb＋）, （HBeAb＋, HBcAb＋）, （HBcAb＋） models, the positive rate in CP group was significantly higher than that of the control group（P〈0.000）.Multivariate regression analysis showed that the positivity of HBsAb and HBeAb were the protection factors for the occurrence of CP（P〈0.05）,and HBcAb positivity was the independent risk factor for CP （OR=6.931,P〈0.000）.Conclusions HBsAb and HBeAb poitivity were the protectors for CP, while HBcAb positivity could be considered as an independent risk factor for CP.