慢性乙型肝炎患者并发原发性肝癌的影响因素分析

Analysis on influencing factors of chronic hepatitis B patients complicated with primary hepatic carcinoma

目的探讨慢性乙型肝炎(CHB)并发原发性肝癌(PHC)的影响因素,为预防和治疗CHB并发PHC提供依据。方法选择2012年2月-2015年2月在奉化市人民院就诊及防保科登记的CHB并发PHC患者128例,1∶1纳入同期同性别、年龄相差5岁以内的未发生CHB患者,通过单因素和多因素非条件Logistic回归分析筛选PHC发生的主要影响因素。结果单因素Logistic回归分析结果显示,吸烟、饮酒、糖尿病史、肝癌家族史、HBV DNA定量>5×106cps/m L、经常食用油炸/烟熏食品、经济不良和未予以抗病毒治疗是CHB并发PHC的危险因素,而经常饮茶、经常食用海鲜、牛奶/豆浆、蔬菜/水果和心情愉快是保护因素。多因素Logistic回归分析结果显示,饮酒、肝癌家族史、HBV DNA定量>5×106cps/m L及发生肝硬化为CHB并发PHC的危险因素;经常食用海鲜、经常食用蔬菜/水果和心情愉快为CHB并发PHC的保护因素。结论在有效治疗CHB患者的同时,应当重视PHC危险因素的预防和控制,提倡健康的生活习惯,平衡膳食,合理营养,保持良好的心态,及时采取干预措施,以减少PHC的发生。

Objective To analyze the influencing factors of chronic hepatitis B（ CHB） complicated with primary hepatic carcinoma（ PHC） and provide the referential data for the prevention and treatment of CHB complicated with PHC. Methods One hundred and twenty-eight patients with CHB complicated PHC from February 2012 to February 2015 in Fenghua hospital and prevention department registered were chosen as observation group. In the same period,according to the matching principle of 1： 1,one hundred and twenty-eight CHB patients with no PHC occurrence,same gender,and difference years（ 5 years） were chosen as control group. Univariate and multivariate unconditional Logistic regression analysis were used to screen the main influencing factors of PHC. Results Single factor logistic regression analysis showed that smoking,drinking,history of diabetes,family history of liver cancer,HBV DNA quantification 5 × 106 cps/ml,fried/smoked foods,bad economic status,no antiviral therapy were risk factors of CHB complicated PHC. Eating seafood,drinking milk/soy milk,eating vegetables/fruits and happy mood were protection factors of CHB complicated PHC. Multiple factors logistic regression result showed drinking,family history of liver cancer,HBV DNA quantification 5 × 106 cps/ml,occur liver cirrhosis were risk factors for CHB complicated PHC; usually eating seafood,eat vegetables/fruits and happy mood were protection factors of CHB complicated PHC. Conclusion While effective treatment of CHB patients,it should pay attention to the prevention and control of risk factors of PHC,promote healthy living habits,reasonable nutrition,balanced diet,maintain a good state of mind,and take measures to intervene in order to reduce the occurrence of PHC.