论文部分内容阅读
目的探讨乙型肝炎病毒(HBV)相关的肝细胞癌患者行肝切除术后短期(1个月)内乙型肝炎再活动的发生情况和危险因素。方法回顾性分析2015年1~12月期间在四川大学华西医院行部分肝切除术的HBV相关肝细胞癌患者的临床资料,并分析影响乙型肝炎再活动发生率的危险因素。结果 214例患者中有15例(7.0%)患者在术后短期内发生了乙型肝炎再活动。单因素分析结果显示,术前HBV-DNA阴性(P=0.023)及乙型肝炎e抗原阳性(P=0.001)与乙型肝炎再活动的发生有关,进一步进行多因素分析结果显示,术前HBV-DNA阴性[OR=9.21,95%置信区间为(2.40,35.45),P=0.001]及乙型肝炎e抗原阳性[OR=20.51,95%置信区间为(5.41,77.73),P<0.001]为部分肝切除术后乙型肝炎再活动的独立危险因素。结论 HBV相关肝细胞癌患者行部分肝切除术后短期内可能出现乙型肝炎再活动,尤其是对于术前HBV-DNA阴性及乙型肝炎e抗原阳性患者在术后短期内应加强HBV-DNA水平的监测,若一旦出现乙型肝炎再活动,应立即启动抗病毒治疗。
Objective To investigate the occurrence and risk factors of hepatitis B reactivation in patients with hepatitis B virus (HBV) -related hepatocellular carcinoma in a short period of one month after hepatectomy. Methods The clinical data of patients with HBV-related hepatocellular carcinoma who underwent partial hepatectomy at West China Hospital of Sichuan University from January to December 2015 were analyzed retrospectively. The risk factors influencing the reactivation rate of hepatitis B were analyzed. Results Of the 214 patients, 15 (7.0%) patients developed hepatitis B reactivation shortly after surgery. Univariate analysis showed that preoperative HBV-DNA negative (P = 0.023) and hepatitis B e antigen positive (P = 0.001) were associated with the occurrence of hepatitis B reactivation. Further multivariate analysis showed that preoperative HBV (OR = 9.21, 95% confidence interval (2.40, 35.45), P = 0.001] and positive for hepatitis B e antigen [OR = 20.51, 95% confidence interval (5.41, 77.73), P <0.001] As a separate risk factor for reactivation of hepatitis B after partial hepatectomy. Conclusions Hepatitis B reactivation may occur in patients with HBV-related hepatocellular carcinoma in the short term after partial hepatectomy. Especially HBV-DNA levels should be strengthened in patients with positive HBV-DNA negative and hepatitis B e antigen positive shortly after operation If monitoring of hepatitis B reactivation occurs, antiviral treatment should be initiated immediately.