摘要
目的了解肝细粒棘球蚴病与HBV/HCV感染、肝硬化、肝细胞癌共患病状态,为进一步探讨肝细粒棘球蚴病对慢性HBV/HCV感染-肝硬化-肝细胞癌的影响奠定基础。方法回顾性分析2003年—2019年石河子大学医学院第一附属医院收治的401例肝细粒棘球蚴病患者资料,明确肝细粒棘球蚴病与慢性HBV/HCV感染、肝硬化、肝细胞癌的共患状态,进一步选取肝细粒棘球蚴病合并慢性HBV/HCV感染病例(共患病组),匹配本院单纯慢性HBV/HCV感染患者为对照组,采用χ^(2)检验、Fisher确切概率法,分析两组病毒感染状态、肝硬化、肝细胞癌的疾病构成。结果共患病组38例(9.5%),合并HBV/HCV感染后肝硬化2例(0.5%),合并HBV/HCV感染后肝细胞癌0例。共患病组的慢性HBV感染者中非活动性HBsAg携带患者占81%,HBeAg阳性CHB患者占9.5%,HBeAg阴性CHB患者占9.5%;单纯慢性HBV/HCV感染组的HBV感染者中非活动性HBsAg携带患者占43%,HBeAg阳性CHB患者占33%,HBeAg阴性CHB患者占19%,差异有统计学意义(P=0.033);共患病组中HCV感染者的HCV RNA转阴率为73%,单纯慢性HBV/HCV感染组HCV感染者的HCV RNA转阴率为40%,差异有统计学意义(χ^(2)=4.447,P=0.035);共患病组肝硬化占5.2%,肝细胞癌为0,对照组肝硬化占18.4%,肝细胞癌占5.2%,共患病组较对照组肝硬化、肝细胞癌比例降低,差异有统计学意义(P=0.048)。结论肝细粒棘球蚴病合并HBV/HCV感染的肝硬化占比较单纯病毒性肝炎少,未发现合并HBV/HCV感染后肝细胞癌病例。肝细粒棘球蚴病对慢性HBV/HCV感染-肝硬化-肝细胞癌的影响需进一步多中心研究。
Objective To investigate the comorbidity of hepatic cystic echinococcosis with HBV/HCV infection,liver cirrhosis,and hepatocellular carcinoma,and to lay a foundation for further research on the influence of hepatic cystic echinococcosis on HBV/HCV infection,liver cirrhosis,and hepatocellular carcinoma.Methods A retrospective analysis was performed for the data of 401 patients with hepatic cystic echinococcosis who were admitted to The First Affiliated Hospital of Shihezi University from 2003 to 2019,and the state of comorbidity of hepatic cystic echinococcosis with HBV/HCV infection,liver cirrhosis,and hepatocellular carcinoma was clarified.The patients with hepatic cystic echinococcosis and chronic HBV/HCV infection were selected as comorbidity group,and the patients with HBV/HCV infection alone were matched as control group.The chi-square test and the Fisher’s exact test were used to analyze the state of viral infection and the disease composition of liver cirrhosis and hepatocellular carcinoma.Results Of all 401 patients,38(9.5%)were included in the comorbidity group and 2(0.5%)had liver cirrhosis after HBV/HCV infection,while no patient had hepatocellular carcinoma after HBV/HCV infection.Among the patients with chronic hepatitis B virus infection in the comorbidity group,non-active HBsAg carriers accounted for 81%,HBeAg-positive chronic hepatitis B patients accounted for 9.5%,and HBeAg-negative chronic hepatitis B patients accounted for 9.5%;among the patients with hepatitis B virus infection in the control group,non-active HBsAg carriers accounted for 43%,HBeAg-positive chronic hepatitis B patients accounted for 33%,and HBeAg-negative chronic hepatitis B patients accounted for 19%,with a significant difference between the two groups(P=0.033).There was a significant difference in the HBV RNA clearance rate of the patients with HCV infection between the comorbidity group and the control group(χ^(2)=4.447,P=0.035).In the comorbidity group,the patients with liver cirrhosis accounted for 5.2%and there were no patients with hepatocellular carcinoma,while in the control group,the patients with liver cirrhosis accounted for 18.4%and those with hepatocellular carcinoma accounted for 5.2%;the comorbidity group had significantly lower proportions than the control group(P=0.048).Conclusion The proportion of liver cirrhosis patients with hepatic cystic echinococcosis and HBV/HCV infection is lower than that of liver cirrhosis patients with viral hepatitis alone,and there are no cases of hepatocellular carcinoma after HBV/HCV infection.Further multicenter studies are needed to investigate the influence of hepatic cystic echinococcosis on chronic HBV/HCV infection,liver cirrhosis,and hepatocellular carcinoma.
作者
满洋
林芷伊
苗章
闫乐蓉
程萧
荆仁一
白蓉
黄平文
张宏伟
彭心宇
MAN Yang;LIN Zhiyi;MIAO Zhang;YAN Lerong;CHENG Xiao;JING Renyi;BAI Rong;HUANG Pingwen;ZHANG Hongwei;PENG Xinyu(Shihezi University School of Medicine,Shihezi,Xinjiang 832000,China;Department of Oncology,The First Affiliated Hospital of Shihezi University School of Medicine,Shihezi,Xinjiang 832000,China;Department of Hepatobiliary Surgery,The First Affiliated Hospital of Shihezi University School of Medicine,Shihezi,Xinjiang 832000,China;NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases,Shihezi,Xinjiang 832000,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2022年第3期601-605,共5页
Journal of Clinical Hepatology
基金
国家自然科学基金(81860363)
湖北陈孝平科技发展基金(CXPJJH11900001-2019313)
中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2020-PT330-003)。
关键词
棘球蚴病
肝
肝炎病毒
肝硬化
癌
肝细胞
Echinococcosis,Hepatic
Hepatitis Viruses
Liver Cirrhosis
Carcinoma,Hepatocellular
