乙型肝炎肝硬化的发病危险因素分析

Screening liver cirrhosis risk factors based on logistic regression analysis

目的:结合中医证候因素,筛选乙型肝炎后肝硬化(LC)发生的危险因素,并建立其风险预测模型。方法:采用前瞻性队列研究的方法,将2007年6月至2017年12月江苏启东市辖区内8个城镇、初次HBsAg阳性的居民纳入研究队列,以末次确诊为LC为终点事件,经Logistic单因素及多因素回归分析,筛选出LC相关危险因素和中医证候要素,建立基于Logistic回归的LC预测模型,并运用Hosmer-Lemeshow拟合优度、AUC指标对其风险预测模型拟合度及准确性进行评价。结果:通过Logistic单因素及多因素回归分析,最终筛选出性别、教育状况、乙型肝炎史、肝癌家族史、血瘀证、实热证是LC发生的危险因素。结论:慢性乙型肝炎史、肝癌家族史、血瘀证、实热证是LC发生的危险因素,女性、较高的学历是LC发生的保护因素。

Objective:Based on the epidemiological survey data of Qidong Liver Cancer Base over the past decade,to combine TCM syndrome factors,establish a risk prediction model for LC and provide data support for the formulation of follow-up TCM intervention plans.Methods:Through a prospective cohort study,residents of 8 cities and towns in the area of Qidong Municipality from June 2007 to December 2017,who had previously demonstrated hepatitis B surface antigen(HBsAg)-positive residents in outpatient or other census,were included in the study,take the final diagnosis in LC as the end point,logistic regression analysis was used to screen LC risk factors combined with syndromes,to establish LC risk prediction models,and to evaluate accuracy by Hosmer Lemeshow and AUC indicators.Results:Through Logistic regression analysis,the influencing factors of LC were gender,educational status,history of CHB,family history of liver cancer,blood stasis syndrome,and real-heat syndrome.Then established a risk prediction model.Conclusion:Female and junior high school education are common protective factors for the occurrence of LC.Chronic hepatitis B history,family history of HCC,blood stasis syndrome and real heat syndrome are risk factors for LC.