中国临床新医学
中國臨床新醫學
중국림상신의학
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
2013年
8期
771-776
,共6页
非酒精性脂肪性肝病%原发性肝癌%临床特征%危险因素
非酒精性脂肪性肝病%原髮性肝癌%臨床特徵%危險因素
비주정성지방성간병%원발성간암%림상특정%위험인소
Nonalcoholic fatty liver disease%Hepatocellular carcinoma ( HCC)%Clinical characteristics%Risk factor
目的探讨非酒精性脂肪性肝病（ NAFLD）伴发原发性肝癌（ HCC）的发病率、临床特征和危险因素。方法采用回顾性分析的方法，选取该院住院确诊的1092例HCC患者，参照2006-02中华医学会肝脏病分会脂肪肝和酒精性肝病学组《非酒精性脂肪性肝病诊疗指南》中关于NAFLD的临床诊断标准，从HCC患者中遴选出符合NAFLD诊断标准的72例患者，分析NAFLD相关HCC的发病率、临床表现及生化指标、影像学特征、生存率及影响预后的危险因素。结果 NAFLD伴发HCC患者共72例，占HCC患者的6.6％，年龄（60.52±10.21）岁，伴有2型糖尿病（T2DM）者35例，占48.6％（35/72），体重指数（BMI）≥26 kg/m2者28例，占38.9％（28/72），伴有高血压病者34例，占47.2％（34/72）。主要临床表现无明显特征性。其生存情况：随访NAFLD伴发HCC病例72例，死亡53例，1、2、3年生存率分别为68.47％、40.26％、30.52％。单因素分析BMI、T2DM、高血压病、谷丙转氨酶（ALT）、总胆红素（TBIL）、直接胆红素（DBIL）、谷氨酰转移酶（GGT）、胆碱酯酶（ CHE）对NAFLD伴发HCC生存率比较差异有统计学意义（ P＜0.05），可能是影响预后的危险因素。多因素分析显示BMI、T2DM是影响预后的独立危险因素。结论 NAFLD是HCC发生的原因之一，肥胖、T2DM是影响NAFLD伴发HCC预后的独立危险因素。
目的探討非酒精性脂肪性肝病（ NAFLD）伴髮原髮性肝癌（ HCC）的髮病率、臨床特徵和危險因素。方法採用迴顧性分析的方法，選取該院住院確診的1092例HCC患者，參照2006-02中華醫學會肝髒病分會脂肪肝和酒精性肝病學組《非酒精性脂肪性肝病診療指南》中關于NAFLD的臨床診斷標準，從HCC患者中遴選齣符閤NAFLD診斷標準的72例患者，分析NAFLD相關HCC的髮病率、臨床錶現及生化指標、影像學特徵、生存率及影響預後的危險因素。結果 NAFLD伴髮HCC患者共72例，佔HCC患者的6.6％，年齡（60.52±10.21）歲，伴有2型糖尿病（T2DM）者35例，佔48.6％（35/72），體重指數（BMI）≥26 kg/m2者28例，佔38.9％（28/72），伴有高血壓病者34例，佔47.2％（34/72）。主要臨床錶現無明顯特徵性。其生存情況：隨訪NAFLD伴髮HCC病例72例，死亡53例，1、2、3年生存率分彆為68.47％、40.26％、30.52％。單因素分析BMI、T2DM、高血壓病、穀丙轉氨酶（ALT）、總膽紅素（TBIL）、直接膽紅素（DBIL）、穀氨酰轉移酶（GGT）、膽堿酯酶（ CHE）對NAFLD伴髮HCC生存率比較差異有統計學意義（ P＜0.05），可能是影響預後的危險因素。多因素分析顯示BMI、T2DM是影響預後的獨立危險因素。結論 NAFLD是HCC髮生的原因之一，肥胖、T2DM是影響NAFLD伴髮HCC預後的獨立危險因素。
목적탐토비주정성지방성간병（ NAFLD）반발원발성간암（ HCC）적발병솔、림상특정화위험인소。방법채용회고성분석적방법，선취해원주원학진적1092례HCC환자，삼조2006-02중화의학회간장병분회지방간화주정성간병학조《비주정성지방성간병진료지남》중관우NAFLD적림상진단표준，종HCC환자중린선출부합NAFLD진단표준적72례환자，분석NAFLD상관HCC적발병솔、림상표현급생화지표、영상학특정、생존솔급영향예후적위험인소。결과 NAFLD반발HCC환자공72례，점HCC환자적6.6％，년령（60.52±10.21）세，반유2형당뇨병（T2DM）자35례，점48.6％（35/72），체중지수（BMI）≥26 kg/m2자28례，점38.9％（28/72），반유고혈압병자34례，점47.2％（34/72）。주요림상표현무명현특정성。기생존정황：수방NAFLD반발HCC병례72례，사망53례，1、2、3년생존솔분별위68.47％、40.26％、30.52％。단인소분석BMI、T2DM、고혈압병、곡병전안매（ALT）、총담홍소（TBIL）、직접담홍소（DBIL）、곡안선전이매（GGT）、담감지매（ CHE）대NAFLD반발HCC생존솔비교차이유통계학의의（ P＜0.05），가능시영향예후적위험인소。다인소분석현시BMI、T2DM시영향예후적독립위험인소。결론 NAFLD시HCC발생적원인지일，비반、T2DM시영향NAFLD반발HCC예후적독립위험인소。
Objective To investigate the incidence , clinical characteristics , risk factors of nonalcoholic fatty liver disease(NAFLD) with primary hepatocellular carcinoma (HCC).Methods A retrospective analysis was per-formed.From 1 092 hospitalized patients with HCC , according to “clinical diagnostic criteria for nonalcoholic fatty liv-er disease in nonalcoholic fatty liver disease diagnosis and treatment guidelines ” of fatty liver and alcoholic liver dis-ease study group of Chinese Liver disease Association ,72 HCC patients were selected who met the diagnostic criteria of NAFLD.In 72 patients with NAFLD with HCC, incidence, clinical and biochemical indexes , imaging characteris-tics, survival rate and the risk factors influencing the prognosis were analyzed .Results In 1 092 HCC patients, there were 72 patients with NAFLD, accounted for 6.6%, average age (60.52 ±10.21 );with type 2 diabetes melli-tus in 35 cases,accounted for 48.6%(35/72);body mass index ≥26 kg/m2 in 28 cases, accounted for 38.9%(28/72);hypertension 34 cases, accounted for 47.2%(34/72).The main clinical manifestations had no obvious charac-teristic.In follow-up of 72 patients with NAFLD with primary HCC, 53 cases died;1, 2, 3 year survival rates were 68.47%, 40.26%, 30.52%.BMI, T2DM, hypertension, ALT, TBIL, DBIL, GGT, CHE on survival rate of NAFLD patients with HCC were statistically significant in univariate analysis , may be the risk factors influencing the prognosis.Multivariate analysis showed that BMI , T2DM were independent prognostic factors .Conclusion NAFLD is the primary reason for the occurrence of HCC .Obesity, T2DM are independent risk factors influencing the prognosis of patients with NAFLD with HCC .
