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目的 了解慢性乙型肝炎的自然史 ,辅助公共卫生决策。方法 建立慢性肝病转归的计算机模型。模型框架包含慢性乙型肝炎 (CHB)、自愈 (NR)、代偿性肝硬化 (CIR)、失代偿性肝硬化(DEC)、原发性肝癌 (HCC)和死亡 (DEA)等阶段。模型假设每年每一阶段患者都以不同的概率向其它可能的阶段转化 ,参考有关文献确定了其间 15个相互转化的概率公式 ,并将它们融合到Foxpro语言编制的模型当中 ,分别对假想的CHB和其他患者进行了长达 5 5年的模拟。结果 CHB发展为NR、CIR、DEC和HCC的中位年数依次为 3、11、2 0和 2 4年 ,CHB、CIR、DEC和HCC发展为DEA的中位年数分别为 30、12、4和不足 1年 ,第 30年时CHB患者的死因构成包括HCC(41.3% )、DEC(33.0 % )和其它疾病 (2 5 .7% )三部分。结论 模型模拟的主要结果经与过去的研究资料比较后证明是可靠的
Objective To understand the natural history of chronic hepatitis B and assist public health decision-making. Methods To establish a computerized model of chronic liver disease. The model framework includes stages of chronic hepatitis B (CHB), self-healing (NR), compensatory cirrhosis (CIR), decompensated cirrhosis (DEC), primary liver cancer (HCC) and death (DEA) . The model assumes that at each stage of the year, patients transition to other possible phases with different probabilities. The probability formulas of the 15 interconversions are determined with reference to the relevant literature and fused into the Foxpro language model for hypothetical CHB A total of 55 years of simulations were performed with other patients. Results The median years of progression of CHB to NR, CIR, DEC and HCC were 3, 11, 20 and 24 years, and the median years of CHB, CIR, DEC and HCC development to DEA were 30, 12, 4 and In less than one year, the cause of CHB death at the 30th year consisted of three parts: HCC (41.3%), DEC (33.0%) and other diseases (25.7%). Conclusions The main results of the model simulations proved to be reliable when compared with past research data