CAJ | 학술논문

目的探讨巴德-吉亚利综合征(B-CS)合并肝细胞癌(HCC)患者的危险因素.方法回顾性分析郑州大学第一附属医院2012年12月至2014年11月收治的临床资料较为完善的30例B-CS合并HCC患者的资料(HCC组),并随机选取同期收治的106例B-CS未合并HCC患者作为对照(非HCC组).分析两组患者的性别、年龄、病史、B-CS类型、血红蛋白、ALT、AST、血清清蛋白、Child-Pugh分级、门静脉主干内径、HBV感染及饮酒史.采用单因素分析及非条件Logistic回归模型筛选B-CS合并HCC的危险因素,绘制受试者工作特征(ROC)曲线并计算曲线下面积,判断各指标的诊断价值.结果单因素分析结果显示,HCC组与非HCC组患者在性别(x2=0.001)、年龄(t =0.317)、病史(t=-0.906)、B-CS类型(x2=2.894)、ALT(t=-1.581)、Child-Pugh分级(Z=-0.777)、HBV感染(x2=0.016)及饮酒史(x2=0.285)方面的差异均无统计学意义(P值均＞0.05).HCC组患者的血红蛋白(t=3.370)、血清清蛋白水平(t=2.152)低于非HCC组,AST(t=-2.425)、门静脉主干内径(t=-2.554)高于非HCC组,差异均有统计学意义(P值均＜0.05).非条件Logistic回归模型分析结果显示,血红蛋白、AST、门静脉主干内径是B-CS合并HCC的独立危险因素(OR =0.972、1.015、1.206,P=0.004、0.022、0.012),ROC曲线分析结果显示,AST、血红蛋白、门静脉主干内径的曲线下面积分别为0.704、0.324、0.624,预测价值依次为AST、门静脉主干内径、血红蛋白.结论血红蛋白、AST、门静脉主干内径是B-CS合并HCC的独立危险因素.
목적 탐토파덕-길아리종합정(B-CS)합병간세포암(HCC)환자적위험인소.방법 회고성분석정주대학제일부속의원2012년12월지2014년11월수치적림상자료교위완선적30례B-CS합병HCC환자적자료(HCC조),병수궤선취동기수치적106례B-CS미합병HCC환자작위대조(비HCC조).분석량조환자적성별、년령、병사、B-CS류형、혈홍단백、ALT、AST、혈청청단백、Child-Pugh분급、문정맥주간내경、HBV감염급음주사.채용단인소분석급비조건Logistic회귀모형사선B-CS합병HCC적위험인소,회제수시자공작특정(ROC)곡선병계산곡선하면적,판단각지표적진단개치.결과 단인소분석결과현시,HCC조여비HCC조환자재성별(x2=0.001)、년령(t =0.317)、병사(t=-0.906)、B-CS류형(x2=2.894)、ALT(t=-1.581)、Child-Pugh분급(Z=-0.777)、HBV감염(x2=0.016)급음주사(x2=0.285)방면적차이균무통계학의의(P치균＞0.05).HCC조환자적혈홍단백(t=3.370)、혈청청단백수평(t=2.152)저우비HCC조,AST(t=-2.425)、문정맥주간내경(t=-2.554)고우비HCC조,차이균유통계학의의(P치균＜0.05).비조건Logistic회귀모형분석결과현시,혈홍단백、AST、문정맥주간내경시B-CS합병HCC적독립위험인소(OR =0.972、1.015、1.206,P=0.004、0.022、0.012),ROC곡선분석결과현시,AST、혈홍단백、문정맥주간내경적곡선하면적분별위0.704、0.324、0.624,예측개치의차위AST、문정맥주간내경、혈홍단백.결론 혈홍단백、AST、문정맥주간내경시B-CS합병HCC적독립위험인소.
Objective To investigate the risk factors of Budd-Chiari syndrome (B-CS) complicated with hepatocellular carcinoma (HCC).Methods The clinical data of 30 patients with B-CS complicated with HCC treated in the First Affiliated Hospital of Zhengzhou University from December 2012 to November 2014 were analyzed retrospectively,106 another patients were selected randomly as control group in the same term.Gender,age,medical history,type of B-CS,hemoglobin,alanine aminotransferase (ALT),aspartate aminotransferase (AST),albumin,Child-Pugh classification,portal vein diameter,HBV infection and drinking history were recorded and analyzed between the two groups.Univariate analysis and unconditional Logistic regression model were performed to screen corresponding risk factors.Area under curve (AUC) was calculated according to receiver operator characteristic (ROC) curve to evaluate the diagnostic value of each indicator.Results Univariate analysis showed that there were no statistical differences in gender (x2 =0.001),age (t =0.317),medical history (t =-0.906),type of B-CS (x2 =2.894),ALT (t =-1.581),Child-Pugh classification(Z =-0.777),HBV infection (x2 =0.016) and drinking history (x2 =0.285)between the two groups(all P ＞ 0.05),but the hemoglobin (t =3.370) and albumin (t =2.152) in HCC group were lower and AST (t =-2.425)and portal vein diameter(t =-2.554) were higher than that in the other group,and the differences were statistically significant (all P ＜ 0.05).The results of unconditional Logistic regression model analysis indicated that hemoglobin,AST and portal vein diameter were independent risk factors of B-CS complicated with HCC (OR =0.972,1.015,1.206;P =0.004,0.022,0.012).ROC curve analysis indicated that the AUC of AST,hemoglobin and portal vein diameter was 0.704,0.324 and 0.624,the predicate value was,in order,AST,portal vein diameter,hemoglobin.Conciusion Hemoglobin,AST and portal vein diameter are independent risk factors of B-CS complicated with HCC.