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新疆地區(qū)隱源性肝硬化的臨床特征及可能病因分析

發(fā)布時(shí)間:2018-02-25 15:11

  本文關(guān)鍵詞: 隱源性肝硬化 病因 原發(fā)性肝癌 高血壓 糖尿病 出處:《新疆醫(yī)科大學(xué)》2014年碩士論文 論文類型:學(xué)位論文


【摘要】:目的:通過分析新疆地區(qū)隱源性硬化患者的臨床特征,探討在乙型肝炎病毒(Hepatitis B virus,HBV)高流行區(qū)域隱源性肝硬化的可能病因。方法:回顧性分析2001年1月-2009年1月新疆醫(yī)科大學(xué)第一附屬醫(yī)院241例符合隱源性肝硬化診斷標(biāo)準(zhǔn)的住院肝硬化病例資料,其中包括隱源性肝硬化患者222例,隱源性肝硬化伴原發(fā)性肝細(xì)胞癌患者19例,對其性別、年齡、民族、合并高血壓、糖尿病等代謝伴發(fā)情況進(jìn)行研究分析。結(jié)果:4023例肝硬化患者中有241例符合隱源性肝硬化的診斷標(biāo)準(zhǔn),占據(jù)總體肝硬化患者的5.99%,在241例患者中有98例(40.66%)合并糖尿病,55例合并高血壓(22.82%),其中222例為單純隱源性肝硬化(平均年齡54.86歲±16.09歲,44%為男性),隱源性肝硬合并肝癌的患者共19例,肝癌的發(fā)生率為7.88%(平均年齡67.42歲±7.03歲,47%為男性),其中隱源性肝硬化組和隱源性肝硬化合并肝癌組的糖尿病發(fā)病率分別為40%和57%,高血壓發(fā)病率分別為20%和58%。單因素分析結(jié)果顯示,單純隱源性肝硬化和隱源性肝硬化合并肝癌患者在年齡和高血壓方面有顯著性差異(t=-6.47,P0.001)和(t=13.8,P0.001),收縮壓和舒張壓在兩組中也有顯著性差異(t=-3.63,P0.001)和(t=-3.42,P0.001),多因素回歸分析顯示年齡、高血壓是隱源性肝硬化發(fā)展為肝癌的獨(dú)立危險(xiǎn)因素(OR=1.086,95%CI:1.03-1.14,P0.001; OR=5.4,95%CI:2.05-14.23,P0.001)。結(jié)論:我們的研究顯示,本組隱源性肝硬化合并較高的2型糖尿病和高血壓代謝綜合征指征,符合非酒精性脂肪肝病的臨床特征,提示作為HBV較高流行的新疆地區(qū)隱源性肝硬化與非酒精脂肪性肝病具有相關(guān)的可能性大。
[Abstract]:Objective: to analyze the clinical characteristics of patients with cryptogenic sclerosis in Xinjiang. To explore the possible etiology of cryptogenic cirrhosis in the high prevalence area of hepatitis B virus hepatitis B. methods: from January 2001 to January 2009, 241 cases of cryptogenic cirrhosis in the first affiliated Hospital of Xinjiang Medical University were analyzed retrospectively. Accurate data of inpatient liver cirrhosis cases, These included 222 patients with cryptogenic cirrhosis and 19 patients with primary hepatocellular carcinoma. Results 241 out of 4023 patients with liver cirrhosis met the diagnostic criteria of cryptogenic cirrhosis. Of the total patients with liver cirrhosis, 5.99m, 98 out of 241 patients (40.66) were associated with diabetes mellitus and 55 patients with hypertension, 222 patients were simple cryptogenic cirrhosis (mean age was 54.86 years 鹵16.09 years old, 44% were male patients, 19 cases of cryptogenic hepatocirrhosis complicated with liver cancer), and there were 19 cases of cryptogenic hepatocirrhosis complicated with liver cancer, among which 222 cases were simple cryptogenic cirrhosis (mean age: 54.86 years 鹵16.09 years old, 44%). The incidence of liver cancer was 7.88% (mean age: 67.42 鹵7.03 years old, 47%). The incidence of diabetes mellitus and hypertension were 40% and 57 in the patients with cryptogenic cirrhosis and hepatocellular carcinoma, respectively. The results of univariate analysis showed that the incidence of diabetes mellitus and hypertension were 20% and 58.The results of univariate analysis showed that. There were significant differences in age and hypertension between patients with simple cryptogenic cirrhosis and cryptogenic cirrhosis with liver cancer. There were significant differences in systolic blood pressure and diastolic blood pressure between the two groups in age and hypertension. Multivariate regression analysis showed that age was significantly higher than that of diastolic blood pressure. Hypertension is an independent risk factor for the development of cryptogenic liver cirrhosis into hepatocellular carcinoma (CI: 1.03-1.14 P0.001). Conclusion: our study shows that cryptogenic cirrhosis is associated with higher type 2 diabetes mellitus and hypertension metabolic syndrome. In accordance with the clinical characteristics of non-alcoholic fatty liver disease, it is suggested that cryptogenic cirrhosis and non-alcoholic fatty liver disease are likely to be related to the prevalence of HBV in Xinjiang.
【學(xué)位授予單位】:新疆醫(yī)科大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2014
【分類號】:R575.2

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