目的探讨乙肝隐匿型感染(occult infection of HBV)在隐源性肝病中的感染率。方法采用PCR技术从健康献血人员与HBsAg阴性的隐源性肝病患者(包括肝硬化、肝癌、丙肝与病因不清肝炎)血清中检测HBV X DNA,统计并分析HBV在各组中的感染率。...目的探讨乙肝隐匿型感染(occult infection of HBV)在隐源性肝病中的感染率。方法采用PCR技术从健康献血人员与HBsAg阴性的隐源性肝病患者(包括肝硬化、肝癌、丙肝与病因不清肝炎)血清中检测HBV X DNA,统计并分析HBV在各组中的感染率。结果隐匿型HBV在健康人群中的感染率为5%,而在隐源性肝硬化、肝癌、丙肝与病因不清肝炎中的感染率分别为30%、20%、32%、7.4%。与健康人群相比,隐源性肝硬化、肝癌与丙肝患者的HBV感染率显著增加、但病因不清肝炎患者HBV感染率却无显著差异。研究还发现,肝硬化与肝癌患者的性别/HBV抗体的检出与HBV感染率的关系不大,但丙肝患者其HBV抗体的检出与HBV感染率有密切的联系。结论本研究小范围内统计了隐匿型HBV在隐源性肝病中的感染率,并证实HBV隐匿型感染在隐源性肝硬化、肝癌患者中与性别、HBV抗体检出没有关系,而在丙肝患者中其与乙肝血清抗体的检出相关。展开更多
Recently,nonalcoholic steatohepatitis(NASH) has been considered to be another cause of liver cirrhosis and hepatocellular carcinoma(HCC).The natural history and prognosis of NASH are controversial.Accordingly,we asses...Recently,nonalcoholic steatohepatitis(NASH) has been considered to be another cause of liver cirrhosis and hepatocellular carcinoma(HCC).The natural history and prognosis of NASH are controversial.Accordingly,we assessed the clinicopathological features of NASH-associated HCC in our experience and reviewed the literature of NASH-associated HCC.We experienced 11 patients with NASH-associated HCC(6 male,5 female;mean age 73.8 ± 4.9 years) who received curative treatments.Most(91%) patients had been diagnosed with obesity,diabetes,hypertension,or dyslipidemia.Seven patients(64%) also had a non-cirrhotic liver.The recurrence-free survival rates at 1,3 and 5 years were 72%,60%,and 60%.We also summarized and reviewed 94 cases of NASH-associated HCC which were reported in the literature(64 male;mean age 66 years).The majority of patients(68%) were obese,66% of patients had diabetes,and 24% had dyslipidemia.Furthermore,26% of the HCCs arose from the non-cirrhotic liver.In conclusion,patients with non-cirrhotic NASH may be a high-risk group for HCC,and regular surveillance for HCC is necessary in non-cirrhotic NASH patients as well as cirrhotic patients.展开更多
目的:了解乙型肝炎中高流行地区乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阴性,乙型肝炎表面抗体/乙型肝炎e抗体/乙型肝炎核心抗体(hepatitis B surface antibody/hepatitis B e antibody/hepatitis B core antibody,anti-H...目的:了解乙型肝炎中高流行地区乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阴性,乙型肝炎表面抗体/乙型肝炎e抗体/乙型肝炎核心抗体(hepatitis B surface antibody/hepatitis B e antibody/hepatitis B core antibody,anti-HBs/anti-HBe/anti-HBc)阳性肝硬化的病因特点.方法:采用回顾性病例对照研究的方法,以2001-01/2013-12新疆医科大学第一附属医院13年的肝硬化住院病例作为研究对象,根据乙型肝炎五项检测结果将HBsAg阴性,但抗-HBs、抗-HBe、抗-HBc中任意一项阳性的肝硬化作为研究组,将同时期临床确诊为隐源性肝硬化的住院病例作为对照组,比较两组一般情况、合并代谢综合征水平及肝细胞肝癌发生情况等.结果:7012例肝硬化住院病例中,符合HBsAg阴性、抗-HBs/抗-HBe/抗-HBc阳性肝硬化220例(占3.14%),符合隐源性肝硬化147例(占2.10%).两组患者,研究组年龄均数显著性低于对照组(P<0.05)、男性患者构成比显著性高于对照组(P<0.05)、汉族患者比例高(P<0.05),研究组具有更高的肝癌发生率(P<0.05),而合并糖尿病、高血压的发生率显著性低于隐源性肝硬化组(P<0.05).结论:HBsAg阴性、抗-HBs/抗-HBe/抗-HBc阳性肝硬化与隐源性肝硬化患者在性别、年龄、合并代谢综合征水平及肝细胞肝癌发生情况等方面均存在统计学差异,提示乙型肝炎标志物阳性组肝硬化患者的病因与隐源性肝硬化存在不同的致病因素,该项研究有助于指导临床医师对两组肝硬化患者的病因诊断.展开更多
文摘目的探讨乙肝隐匿型感染(occult infection of HBV)在隐源性肝病中的感染率。方法采用PCR技术从健康献血人员与HBsAg阴性的隐源性肝病患者(包括肝硬化、肝癌、丙肝与病因不清肝炎)血清中检测HBV X DNA,统计并分析HBV在各组中的感染率。结果隐匿型HBV在健康人群中的感染率为5%,而在隐源性肝硬化、肝癌、丙肝与病因不清肝炎中的感染率分别为30%、20%、32%、7.4%。与健康人群相比,隐源性肝硬化、肝癌与丙肝患者的HBV感染率显著增加、但病因不清肝炎患者HBV感染率却无显著差异。研究还发现,肝硬化与肝癌患者的性别/HBV抗体的检出与HBV感染率的关系不大,但丙肝患者其HBV抗体的检出与HBV感染率有密切的联系。结论本研究小范围内统计了隐匿型HBV在隐源性肝病中的感染率,并证实HBV隐匿型感染在隐源性肝硬化、肝癌患者中与性别、HBV抗体检出没有关系,而在丙肝患者中其与乙肝血清抗体的检出相关。
文摘Recently,nonalcoholic steatohepatitis(NASH) has been considered to be another cause of liver cirrhosis and hepatocellular carcinoma(HCC).The natural history and prognosis of NASH are controversial.Accordingly,we assessed the clinicopathological features of NASH-associated HCC in our experience and reviewed the literature of NASH-associated HCC.We experienced 11 patients with NASH-associated HCC(6 male,5 female;mean age 73.8 ± 4.9 years) who received curative treatments.Most(91%) patients had been diagnosed with obesity,diabetes,hypertension,or dyslipidemia.Seven patients(64%) also had a non-cirrhotic liver.The recurrence-free survival rates at 1,3 and 5 years were 72%,60%,and 60%.We also summarized and reviewed 94 cases of NASH-associated HCC which were reported in the literature(64 male;mean age 66 years).The majority of patients(68%) were obese,66% of patients had diabetes,and 24% had dyslipidemia.Furthermore,26% of the HCCs arose from the non-cirrhotic liver.In conclusion,patients with non-cirrhotic NASH may be a high-risk group for HCC,and regular surveillance for HCC is necessary in non-cirrhotic NASH patients as well as cirrhotic patients.
文摘目的:了解乙型肝炎中高流行地区乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阴性,乙型肝炎表面抗体/乙型肝炎e抗体/乙型肝炎核心抗体(hepatitis B surface antibody/hepatitis B e antibody/hepatitis B core antibody,anti-HBs/anti-HBe/anti-HBc)阳性肝硬化的病因特点.方法:采用回顾性病例对照研究的方法,以2001-01/2013-12新疆医科大学第一附属医院13年的肝硬化住院病例作为研究对象,根据乙型肝炎五项检测结果将HBsAg阴性,但抗-HBs、抗-HBe、抗-HBc中任意一项阳性的肝硬化作为研究组,将同时期临床确诊为隐源性肝硬化的住院病例作为对照组,比较两组一般情况、合并代谢综合征水平及肝细胞肝癌发生情况等.结果:7012例肝硬化住院病例中,符合HBsAg阴性、抗-HBs/抗-HBe/抗-HBc阳性肝硬化220例(占3.14%),符合隐源性肝硬化147例(占2.10%).两组患者,研究组年龄均数显著性低于对照组(P<0.05)、男性患者构成比显著性高于对照组(P<0.05)、汉族患者比例高(P<0.05),研究组具有更高的肝癌发生率(P<0.05),而合并糖尿病、高血压的发生率显著性低于隐源性肝硬化组(P<0.05).结论:HBsAg阴性、抗-HBs/抗-HBe/抗-HBc阳性肝硬化与隐源性肝硬化患者在性别、年龄、合并代谢综合征水平及肝细胞肝癌发生情况等方面均存在统计学差异,提示乙型肝炎标志物阳性组肝硬化患者的病因与隐源性肝硬化存在不同的致病因素,该项研究有助于指导临床医师对两组肝硬化患者的病因诊断.