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目的探讨2型糖尿病是否增加乙型病毒性肝炎肝硬化患者发生原发性肝细胞肝癌(hepatocellular carcinoma,HCC)的风险。方法 450例乙型病毒性肝炎肝硬化患者,依据是否合并HCC分为对照组301例和HCC组149例,比较2组2型糖尿病患病情况及临床特征,logistic回归分析2型糖尿病与HCC的相关性。结果 HCC组2型糖尿病患病率(20.8%),男性比例(84.6%),有吸烟史比例(46.3%),甲胎蛋白>400μg/L比例(51.0%)、血糖((5.89±2.43)mmol/L)、白蛋白((34.7±6.1)g/L)、谷丙转氨酶(56(35,95)u/L)、γ-谷氨酰转肽酶(102(53,258)u/L)、总胆红素(16(8,33)μmol/L)与对照组(31.9%、66.8%,32.6%、4.3%、(6.51±3.11)mmol/L、(31.9±6.5)g/L、38(24,70)u/L、37(24,65)u/L)比较差异有统计学意义(P<0.05或P<0.01);logistic多因素回归分析结果显示,2型糖尿病(OR=0.324,95%CI:0.173~0.805,P=0.010)、甲胎蛋白>400μg/L(OR=22.385,95%CI:8.500~58.634,P=0.000)、谷丙转氨酶(OR=0.993,95%CI:0.985~0.997,P=0.023)、γ-谷氨酰转肽酶(OR=1.004,95%CI:1.000~1.007,P=0.039)、总胆红素(OR=1.017,95%CI:1.000~1.038,P=0.000)、白蛋白(OR=1.065,95%CI:1.005~1.135,P=0.046)与乙型病毒性肝炎肝硬化患者发生HCC相关。结论 2型糖尿病与乙型病毒性肝炎肝硬化患者发生HCC有关。
Objective To investigate whether type 2 diabetes increases the risk of developing primary hepatocellular carcinoma (HCC) in cirrhotic patients with viral hepatitis B (HBV). Methods A total of 450 hepatitis B patients with cirrhosis were divided into control group (n = 301) and HCC group (n = 149) according to whether they were complicated with HCC. The prevalence and clinical characteristics of type 2 diabetes mellitus were compared between the two groups. Logistic regression analysis was used to analyze the relationship between type 2 diabetes mellitus and HCC Correlation. Results The prevalence of type 2 diabetes mellitus (20.8%), male (84.6%), smoking history (46.3%), alpha fetoprotein> 400μg / L (51.0%) and blood sugar (5.89 ± 2.43) (34.7 ± 6.1) g / L), alanine aminotransferase (56 (35,95) u / L), γ- glutamyl transpeptidase (31.9%, 66.8%, 32.6%, 4.3%, (6.51 ± 3.11) mmol / L, (31.9 ± 6.5) g / L) and total bilirubin 38 (24,70) u / L, 37 (24,65) u / L) were significantly different (P <0.05 or P <0.01). Logistic regression analysis showed that type 2 diabetes mellitus (OR = (OR = 22.385, 95% CI: 8.500-58.634, P = 0.000), alanine aminotransferase (OR = 0.993, 95% CI: 0.174-0.9580, P = 0.010) (OR = 1.004, 95% CI: 1.000-1.007, P = 0.039), total bilirubin (OR = 1.017, 95% CI: 0.985-0.997, P = 0.023) (OR = 1.065, 95% CI: 1.005-1.1350, P = 0.046) were associated with HCC in cirrhotic patients with viral hepatitis B (1.000-1.0838, P = 0.000) Conclusion Type 2 diabetes is associated with HCC in cirrhotic patients with hepatitis B virus.