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目的探讨肝炎后肝硬变形成的危险因素.方法建立一人一卡,每年随访和门诊检查一次,对贵州省5家医院2250例乙肝患者进行5a 追踪调查及干预对照试验,5a后追踪率达90.28%.调查内容包括性别、年龄、吸烟史、饮酒史、蛋白摄入水平、乙肝家族史、负性因素(即心理因素,如:亲人死亡、意外打击、家庭不和、工作不顺、对疾病的恐惧、焦虑等)及治疗史,采用 X~2检验各种单因素,有显著意义者再分别计算其相对危险度(RR)值及其可信区间(95%CI),观察与肝炎后肝硬变形成相关的危险因素.干预组定期给予预防肝硬变的卫生健康知识强化宣传,提出合理饮食、戒酒及心理咨询、定期服用保肝药等.结果 HBeAg、抗-HBe、HBVDNA(RR 值1.21～9.82)、抗-HCV(RR 值5.50)持续阳性、乙肝家族史(RR 值14.71)、饮酒(RR 值9.82)、低蛋白饮食(RR 值6.64),心理因素(RR 值8.92)与肝硬变形成相关.干预对照试验表明,5a 后干预组肝硬变的发生率10.58%,对照组为22.91%(P<0.05).结论乙肝病毒(HBV)持续复制、合并丙肝病毒(HCV)感染、乙肝家族史、饮酒、低蛋白饮食及心理因素是肝炎后肝硬变形成的危险因素.
Objective To investigate risk factors for hepatitis formed cirrhosis. Establish a person a card method, and outpatient follow-up inspection once a year, to 2250 cases of hepatitis B patients in Guizhou five hospital for follow-up investigation and intervention 5a-controlled trial, the rate of 90.28 5a track %. The survey included sex, age, smoking history, drinking history, protein intake, family history of hepatitis B, negative factors (ie psychological factors such as: death of a loved one, accidental blow, family disagreement, Anxiety, etc.) and the history of treatment. The relative risk (RR) and its confidence interval (95% CI) were calculated by X ~ 2 test of single-factor, the formation of cirrhosis-related risk factors in the intervention group regularly giving health knowledge of health prevention cirrhosis strengthen propaganda, reasonable diet, alcohol and psychological counseling, regular use of liver medicine, etc. the results HBeAg, anti -HBe, HBVDNA ( (RR of 1.21 to 9.82), anti-HCV (RR of 5.50), positive family history of hepatitis B (RR of 14.71), alcohol consumption (RR of 9.82), low protein diet (RR of 6.64) Related to cirrhosis, Interventions Controlled trials The incidence of liver cirrhosis was 10.58% in the intervention group and 22.91% in the control group (P <0.05) .Conclusion The continuous replication of hepatitis B virus (HBV), combined with hepatitis C virus (HCV) infection, family history of hepatitis B, alcohol consumption, low Protein diet and psychological factors are the risk factors of posthepatitic cirrhosis.