目的:通过对单中心大样本慢性乙型肝炎病毒(hepatitis B virus,HBV)感染队列的分析,对我国慢性HBV感染自然病程的划分提出修订建议。方法:回顾性地纳入2014年1月至2020年10月在中国人民解放军总医院第五医学中心接受过肝组织活检的慢性...目的:通过对单中心大样本慢性乙型肝炎病毒(hepatitis B virus,HBV)感染队列的分析,对我国慢性HBV感染自然病程的划分提出修订建议。方法:回顾性地纳入2014年1月至2020年10月在中国人民解放军总医院第五医学中心接受过肝组织活检的慢性HBV感染者。参考《欧洲肝病学会乙型肝炎病毒感染管理临床实践指南(2017年版)》等国内外最新版慢性乙型肝炎(chronic hepatitis B,CHB)防治指南,将患者按乙型肝炎e抗原(hepatitis B e antigen,HBeAg)状态及肝损伤程度分为HBeAg阳性感染(免疫耐受期)、HBeAg阳性CHB(免疫清除期)、HBeAg阴性感染(免疫控制期)和HBeAg阴性CHB(再活动期)四个自然病程分期,并重点比较了不同分期患者的人口学和实验室检验结果。两组间年龄差异采用Mann-Whitney U检验。结果:最终纳入符合纳排标准的患者760例,包括197例未成年(年龄<18岁)和563例成年感染者,男性456例、女性304例,纳入患者的中位年龄为29岁,(四分位间距:16,39岁)。上述四个自然病程分期患者分别有173、329、95和163例,进一步比较四期患者的年龄发现:HBeAg阴性CHB的中位年龄尽管大于HBeAg阳性CHB(37岁vs.24岁,P<0.001),但却小于HBeAg阴性感染者(37岁vs.39岁,P=0.240)。结论:根据本研究可以推测,HBeAg阴性CHB患者并非都是由HBeAg阴性感染者进入再活动期发展而来,也可以由仍处于持续免疫活动状态的HBeAg阳性CHB患者发生HBeAg阴转或血清学转换而来。展开更多
Objective:To investigate the factors related to renal impairment in patients with diabetic kidney disease(DKD)from the perspective of integrated Chinese and Western medicine.Methods:Totally 492 patients with DKD in 8 ...Objective:To investigate the factors related to renal impairment in patients with diabetic kidney disease(DKD)from the perspective of integrated Chinese and Western medicine.Methods:Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included.According to Kidney Disease Improving Global Outcomes(KDIGO)staging guidelines,patients were divided into a chronic kidney disease(CKD)1-3 group and a CKD 4-5 group.Clinical data were collected,and logistic regression was used to analyze the factors related to different CKD stages in DKD patients.Results:Demographically,male was a factor related to increased CKD staging in patients with DKD(OR=3.100,P=0.002).In clinical characteristics,course of diabetes>60 months(OR=3.562,P=0.010),anemia(OR=4.176,P<0.001),hyperuricemia(OR=3.352,P<0.001),massive albuminuria(OR=4.058,P=0.002),atherosclerosis(OR=2.153,P=0.007)and blood deficiency syndrome(OR=1.945,P=0.020)were factors related to increased CKD staging in patients with DKD.Conclusion:Male,course of diabetes>60 months,anemia,hyperuricemia,massive proteinuria,atherosclerosis,and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD.(Registration No.NCT03865914).展开更多
文摘目的:通过对单中心大样本慢性乙型肝炎病毒(hepatitis B virus,HBV)感染队列的分析,对我国慢性HBV感染自然病程的划分提出修订建议。方法:回顾性地纳入2014年1月至2020年10月在中国人民解放军总医院第五医学中心接受过肝组织活检的慢性HBV感染者。参考《欧洲肝病学会乙型肝炎病毒感染管理临床实践指南(2017年版)》等国内外最新版慢性乙型肝炎(chronic hepatitis B,CHB)防治指南,将患者按乙型肝炎e抗原(hepatitis B e antigen,HBeAg)状态及肝损伤程度分为HBeAg阳性感染(免疫耐受期)、HBeAg阳性CHB(免疫清除期)、HBeAg阴性感染(免疫控制期)和HBeAg阴性CHB(再活动期)四个自然病程分期,并重点比较了不同分期患者的人口学和实验室检验结果。两组间年龄差异采用Mann-Whitney U检验。结果:最终纳入符合纳排标准的患者760例,包括197例未成年(年龄<18岁)和563例成年感染者,男性456例、女性304例,纳入患者的中位年龄为29岁,(四分位间距:16,39岁)。上述四个自然病程分期患者分别有173、329、95和163例,进一步比较四期患者的年龄发现:HBeAg阴性CHB的中位年龄尽管大于HBeAg阳性CHB(37岁vs.24岁,P<0.001),但却小于HBeAg阴性感染者(37岁vs.39岁,P=0.240)。结论:根据本研究可以推测,HBeAg阴性CHB患者并非都是由HBeAg阴性感染者进入再活动期发展而来,也可以由仍处于持续免疫活动状态的HBeAg阳性CHB患者发生HBeAg阴转或血清学转换而来。
基金Supported by National Natural Science Foundation of China for Youth(No.81700629)the State Key Research and Development Program(Nos.2018YFC1704203,2018YFC1704200 and 2019Zx09201-005)Beijing Science and Technology Plan Project(No.D171100002817002)。
文摘Objective:To investigate the factors related to renal impairment in patients with diabetic kidney disease(DKD)from the perspective of integrated Chinese and Western medicine.Methods:Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included.According to Kidney Disease Improving Global Outcomes(KDIGO)staging guidelines,patients were divided into a chronic kidney disease(CKD)1-3 group and a CKD 4-5 group.Clinical data were collected,and logistic regression was used to analyze the factors related to different CKD stages in DKD patients.Results:Demographically,male was a factor related to increased CKD staging in patients with DKD(OR=3.100,P=0.002).In clinical characteristics,course of diabetes>60 months(OR=3.562,P=0.010),anemia(OR=4.176,P<0.001),hyperuricemia(OR=3.352,P<0.001),massive albuminuria(OR=4.058,P=0.002),atherosclerosis(OR=2.153,P=0.007)and blood deficiency syndrome(OR=1.945,P=0.020)were factors related to increased CKD staging in patients with DKD.Conclusion:Male,course of diabetes>60 months,anemia,hyperuricemia,massive proteinuria,atherosclerosis,and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD.(Registration No.NCT03865914).
