摘要
目的了解血吸虫性肝纤维化转变为肝癌的影响因素,为更好的防治该病奠定基础。方法通过问卷调查、临床病历资料分析以及相关实验室检查,比较单纯纤维化组和肝纤维化癌变组各项指标的区别。结果长期吸烟、饮酒的患者其肝纤维化进展为肝癌几率显著高于非吸烟、饮酒患者(吸烟:χ2=4.762,P<0.05;饮酒:χ2=25.073,P<0.05)。肝炎病毒感染显著提高了纤维化患者的癌变率(χ2=6.663,P<0.05)。病原学指标中,感染机会的多少与癌变率有关,感染次数多的患者的癌变率为19.1%,显著高于感染次数少的患者(χ2=20.545,P<0.05)。长期接触疫水的患者其癌变率也显著高于非长期接触疫水的患者(χ2=6.227,P<0.05)。随着反应纤维化程度指标的升高,癌变率逐渐升高(TGF-β1:t=27.414,P<0.05;TIMP-1:t=20.463,P<0.05)。其他一些因素如肝细胞损伤的严重程度以及患者的免疫状况也影响血吸虫性肝纤维化的癌变几率。结论血吸虫性肝纤维化的癌变与生活习惯(吸烟、饮酒)、感染机会多少以及患者病变程度有关。在治疗中应该采取综合措施,加强指标监测,改善患者预后。
Objective In order to lay a basis for the prevention and treatment of schistosomiasis liver fibrosis malignant transformation, risk factors that may play roles in it were investigated. Methods Factors difference in liver fibrosis and malignant transformation group were analyzed through questionnaires, medical records and related clinical laboratory tests. Results Patients of liver fibrosis, who conduct long-term smoking, alcohol consumption had a higher liver cancer risk than non-smoking, drinking groups （ smokers ： X2 = 4. 762, P 〈 0.05 ; Drinking： X2 = 25. 073, P 〈 0.05 ）. Hepatitis virus infection significantly increased rate of canceration in patients with fibrosis （ x2 = 6. 663, P 〈 0.05）. The more chances of being infected,the higher malignant transformation happened. The canceration rate of patients who got infected above 5 times was 19.1%, significantly higher than patients with fewer infections （x2 = 20. 545, P 〈 0.05 ）. Patients who longterm exposure to contaminated water had a higher cancer rate than its counterparts, with significantly different （X2 = 6. 227, P 〈 0.05 ）. With the severity of fibrosis increased, cancer rates gradually increased （ TGF-β1 ： t = 27. 414, P 〈 0. 05 ;TIMP-1 ： t = 20. 463, P 〈 0. 05 ）. Other factors such as the severity of liver cell injury and the immune status of patients with liver fibrosis also influenced the cancer risk. Conclusion Comprehensive prevention and control measures should be adopted for cancer caused by schistosomiasisous liver fibrosis. More factors surveyed were helpful for early detection of abnormalities and improving patients＇ prognosis.
出处
《中华全科医学》
2014年第3期424-426,共3页
Chinese Journal of General Practice
关键词
血吸虫
肝纤维化
恶变
危险因素
Schistosomiasis
Liver fibrosis
Malignant transformation
Risk factors
