酒精性肝硬化进展至肝癌的机制研究

Study on the Mechanism of Alcoholic Liver Cirrhosis Progressing to Liver Cancer

目的:探讨酒精性肝硬化进展至肝癌的机制。方法:选取我院于2016年1月—2018年12月收治的102例酒精性肝硬化患者为研究对象,随访2年后按是否发生肝癌分为进展组33例和对照组69例,同时选取40例健康体检者为健康组。比较三组肝功能、免疫功能、营养状况以及血清学指标,并分析酒精性肝硬化进展至肝癌的影响因素。结果:健康组和对照组肝功能均优于进展组(P<0.05);健康组和对照组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于进展组,CD8^(+)低于进展组(P<0.05);健康组和对照组PA、ALB、TP、Hb水平均优于进展组(P<0.05);健康组和对照组AFP、血清肌肉生长抑素和多配体蛋白聚糖-1均低于进展组(P<0.05);Logistic回归分析显示,免疫功能低下、营养状况不佳、AFP增高、肌肉生长抑素增高、多配体蛋白聚糖-1增高是酒精性肝硬化进展至肝癌的影响因素。结论:酒精性肝硬化进展至肝癌的影响因素有免疫功能低下、营养状况不佳、AFP增高、肌肉生长抑素增高、多配体蛋白聚糖-1增高,临床应据此展开合理干预。

Objective:To investigate the mechanism of alcoholic liver cirrhosis progressing to liver cancer.Methods:A total of 102 patients with alcoholic liver cirrhosis admitted to our hospital from January 2016 to 2018 were selected as the research objects.They were followed up for 2 years.According to whether liver cancer occurred,they were divided into 33 cases in the progression group and 69 cases in the control group.40 cases were selected at the same time.The healthy group was the healthy group.Compared the 3 groups of liver function,immune function,nutritional status,and serological indicators,and analyzed the influencing factors of alcoholic cirrhosis to liver cancer.Results:The liver function of the healthy group and the control group was better than that of the progress group(P<0.05);the CD3^(+),CD4^(+),CD4^(+)/CD8^(+)of the healthy group and the control group were higher than those of the progress group,and CD8^(+)was lower than the progress group(P<0.05);the levels of PA,ALB,TP,and Hb in the control group and the control group were better than those in the progress group(P<0.05);the healthy group and the control group AFP,serum myostatin and proteoglycan-1 were lower than those in the progress group(P<0.05);Logistic regression analysis showed that immunodeficiency,poor nutritional status,increased AFP,increased myostatin,and increased proteoglycan-1 were the influencing factors for the progression of alcoholic liver cirrhosis to liver cancer.Conclusion:The influencing factors for the progression of alcoholic cirrhosis to liver cancer include weakened immune function,poor nutritional status,increased AFP,increased myostatin,and increased polyligand proteoglycan-1,and clinical interventions should be made accordingly.