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目的探讨乙型肝炎病毒(HBV)感染与常德市居民原发性肝癌(PHC)发生的关系。方法采用回顾性调查方法,对常德市居民PHC住院病历364例、消化系统非肝癌住院病历365例及健康体检者380例HBV感染状况进行统计、分析。结果①肝癌组HBV感染模式以HBsAg、抗-HBe和抗-HBc阳性(小三阳)多见,HBsAg、抗-HBc阳性次之。②肝癌组HBV总感染率与HBsAg携带率明显高于两对照组(P<0.005),两者的相对危险度(RR)均大于1,归因危险度百分比(AR%)接近或超过75%;抗-HBs阳性率肝癌组明显低于两对照组(P<0.005),相对危险度(RR)明显小于1。③PHC患者HBV感染率男性较高而女性较低(P<0.005);HBV感染者发病年龄较早而非感染者相对滞后(P<0.01)。结论常德市PHC与HBV感染关系密切,HBV感染是常德市PHC的主要病原学因素;抗-HBs对PHC的发生具有明显的保护作用。积极预防和控制HBV感染流行,是减少PHC发生的关键所在,乙肝疫苗接种对PHC应具有良好的预防作用。
Objective To investigate the relationship between hepatitis B virus (HBV) infection and the occurrence of primary liver cancer (PHC) in Changde City. Methods A retrospective survey was conducted to analyze the prevalence of HBV infection in 364 PHC cases, 365 cases of digestive system non-HCC inpatients and 380 cases of healthy subjects. Results ① The patterns of HBV infection in HCC patients were more common with HBsAg, anti-HBe and anti-HBc positive (Xiaosanyang), HBsAg and anti-HBc. ② The total HBV infection rate and HBsAg carrier rate in HCC group were significantly higher than those in the two control groups (P <0.005). The relative risk (RR) of both groups were both higher than 1 and the AR% was close to or over 75% ; The positive rate of anti-HBs in liver cancer group was significantly lower than that of the two control groups (P <0.005), the relative risk (RR) was significantly less than 1. ③ The prevalence of HBV infection in PHC patients was higher than that in women (P <0.005). HBV infection was older but non-infected (P <0.01). Conclusion PHC in Changde City is closely related to HBV infection. HBV infection is the major etiological factor of PHC in Changde City. Anti-HBs has obvious protective effect on PHC. Active prevention and control of HBV infection is the key to reduce the occurrence of PHC, hepatitis B vaccination should have a good preventive effect on PHC.