摘要
目的分析乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)单一感染及合并感染肝癌(HCC)与非病毒感染HCC(UV-HCC)患者不同临床指标的变化差异,并探讨其在HCC中的预后价值。方法回顾性分析延边大学附属医院2000—2016年HCC患者2 634例,按病因学分为HBV-HCC组、HCV-HCC组、HBV/HCV-HCC组、UV-HCC组,比较各组在不同临床指标上的变化差异,并与终末期肝病模型(MELD)评分进行相关性分析,探索其预后价值。结果四组血小板(PLT)、血红蛋白(Hb)、凝血酶原时间(PT)、国际标准化比值(INR)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、清蛋白(ALB)、谷氨酰转肽酶(GGT)、总胆红素(TBIL)、空腹血糖(GLU)指标均有明显差异(P<0.01);而四组尿素氮(BUN)、血清肌酐(CREA)水平比较,差异均无统计学意义(P>0.05)。Spearman等级相关分析结果显示,HCC患者PT、INR、AST、ALT、GGT、TBIL、CREA指标与MELD评分均存在显著相关性(P<0.001)。结论 UV-HCC与HBV-HCC、HCV-HCC和HBV/HCV-HCC在PLT、PT、INR、AST、ALT、ALB、GGT、TBIL水平上均有显著差异,而HCV-HCC与HBV/HCV-HCC在各指标水平上均无显著差异;HBV-HCC中PLT、Hgb、ALB、GGT水平均高于HCV-HCC。PT、INR、AST、ALT、GGT、TBIL、CREA与HCC的预后显著相关,且不同指标在不同病因HCC患者中的预后价值不同,GGT在HBV-HCC患者中的预后价值显著优于其他指标。
Objective To analysis the variation of clinical index expression between hepatocellular carcinoma （HCC） patients caused by hepatitis B virus （HBV）, hepatitis C virus（HCV） single or combined infection and HCC patients caused by non-viral infections（UV-HCC）. Methods Retrospective analysis of Affiliated Hospital of Yanbian University 2 634 cases of HCC patients fi＇om 2000 to 2016, according to the etiology patients were divided into HBV-HCC group, HCV-HCC group, HBV/ HCV-HCC group and UV-HCC group, compared the variation of different clinical indicators between groups and evaluate the prognostic value by correlation analysis with MELD score. Results Platelet（PLT） ,hemoglobin （Hb）,prothrombin time （PT）, international standardization ratio （INR）, alanine aminotransferase（ALT）, aspartate aminotransferase （AST）, albumin （ALB）, glutamyl transpeptidase （GGT）, total bilirubin （TBIL） were all different in the four groups, the differences were statistically significant（P〈0.01）.There was no difference between BUN and CREA in the four groups, there were no statistical significance （P〉0.05）.The results of Spearman rank con＇elation showed that PT, INR, AST, ALT, GGT, TBIL, CREA were significantly- cor- related with MELD score in HCC patients （P〈0.001）. Conclusion There are significant differences in the levels of PLT, PT, INR, AST, ALT, ALB, GGT and TBIL in HCC patients with virus infection and non-viral infections. All indicators have no dif- ferences in HCC patients caused by HBV, HCV single or combined infection; in HBV-HCC patients PLT, Hbg, ALB and GGT was higher than HCV-HCC patients. PT, INR, AST, ALT, GGT, TBIL, CREA are significantly correlated with the prognosis of liver cancer, and the prognostic value of different indicators in HCC patients caused by different etiology are different. The prog- nostic value of GGT is significantly- better than other indicators in HBV-HCC patients.
作者
曹艳平
隋洪婷
潘猛
曲宝聚
朴红心
CAO Yanping;SUI Hongting;PAN Meng;QU Baoju;PIA O Hongxin(Affiliated Hospital of Yanbian University,Yan-ji,Jilin 133000,China)
出处
《现代医药卫生》
2018年第21期3271-3274,共4页
Journal of Modern Medicine & Health
基金
国家自然基金资助项目(81360075)
关键词
肝癌
肝炎病毒属
预后
临床指标
Liver neoplasms
Hepacivirus
Prognosis
Clinical indicators
