CAJ | 학술논문

目的探讨慢性乙型肝炎患者病程中血清乙型肝炎病毒(HBV)-DNA水平的变化与肝硬化发生的关系.方法收集2001至2007年经肝穿刺确诊的239例慢性乙型肝炎患者.中位随访时间28个月,检测入选和随访终点的血清HBV-DNA水平,观察肝硬化发生情况.结果发生肝硬化者较无肝硬化者年龄更大,随访终点HBV-DNA水平更高,但两组入选时HBV-DNA水平差异无统计学意义(P=0.531).Kaplan-Meier法生存分析显示,随访终点HBV-DNA水平越高,发生肝硬化比例亦越高(X2=11.736,P=0.019).Cox比例风险模型显示,随访终点HBV-DNA水平、入选时的肝组织纤维化分期、乙型肝炎病毒e抗原阴性和γ-谷氨酰转肽酶水平为预示肝硬化发生的危险因素,风险比分别为1.898、1.918、8.976、1.006.结论随访终点HBV-DNA和慢性乙型肝炎肝硬化的发生密切相关.
목적 탐토만성을형간염환자병정중혈청을형간염병독(HBV)-DNA수평적변화여간경화발생적관계.방법 수집2001지2007년경간천자학진적239례만성을형간염환자.중위수방시간28개월,검측입선화수방종점적혈청HBV-DNA수평,관찰간경화발생정황.결과 발생간경화자교무간경화자년령경대,수방종점HBV-DNA수평경고,단량조입선시HBV-DNA수평차이무통계학의의(P=0.531).Kaplan-Meier법생존분석현시,수방종점HBV-DNA수평월고,발생간경화비례역월고(X2=11.736,P=0.019).Cox비례풍험모형현시,수방종점HBV-DNA수평、입선시적간조직섬유화분기、을형간염병독e항원음성화γ-곡안선전태매수평위예시간경화발생적위험인소,풍험비분별위1.898、1.918、8.976、1.006.결론 수방종점HBV-DNA화만성을형간염간경화적발생밀절상관.
Objective To investigate the relationship between HBV-DNA level during the course and progress tO cirrhosis in patients with chronic hepatitis B.Methods From 2001 to 2007,a total of 239 chronic hepatitis B patients confirmed by liver biopsy were followed up for a median time of 28 months.HBV-DNA level was measured at baseline and end point.Results Those who progressed to cirrhosis were older and with higher HBV-DNA levels at the end point.Kaplan-Meier analysis showed that the higher the HBV-DNA level at end point,the higher the risk to cirrhosis(X2=11.736,P=0.019).There was no difference between patients with and without cirrhosis at baseline of HBV-DNA level(P=0.531).The Cox regression indicated that the independent risk factors of cirrhosis were as followings:HBV-DNA level at the end point,stage of fibrosis,hepatitis B e antigen negative and γ-glutamyl transpeptidase at entry with relative risk ratio of 1.898,1.918,8.976 and 1.006,respectively.Conclusion HBV-DNA level is correlated with progress to cirrhosis in patients with chronic hepatitis B.