| Purpose:According to the long-term chronic hepatitis B visit data, through the patient’s personal circumstances, various factors indicators of liver function, hepatitis B virus quantitative indicators, as well as liver biopsy analyzed, discussed further in patients with chronic hepatitis B develop cirrhosis of The main influencing factors.Method:The research is mixed cohort study, a cohort study model will be proactive and combine historical cohort study, therefore, both the advantages of a prospective cohort studies and historical cohort study, and relative to some extent, to make up for their deficiencies. The project collected a total of 160 cases from May 2010 to May 2015 suffering from "chronic hepatitis B" Check Yankuang Group General Hospital of Infectious Diseases liver puncture biopsy patients. Statistical analysis of individual and general condition of the patient, the patient liver function, hepatitis B patients five indicators, quantitative HBVDNA virus in patients, as well as staging liver biopsy grade and so on. And continued follow-up of patients, to grasp the situation and treatment of patients with hepatitis B patients the presence or absence of cirrhosis. Primarily for the diagnosis of cirrhosis diagnosis through imaging diagnosis and clinical evaluation of the patient. By the time of follow-up in the end of July 2015. The study was analyzed using SPSS18.0, mainly used for survival analysis KaPlan-Meier method, a method to compare survival curves using the Log-rank test. Finally, Cox regression model approach to the development of hepatitis were analyzed for a variety of factors cirrhosis.Result:1. The follow-up time was from 3 months to 62 months, with a median follow-up time was 29 months. A total of 20 cases of hepatitis B patients with cirrhosis (12.5%).2. Patients with liver cirrhosis and liver cirrhosis was the result did not occur in contrast, cirrhosis group were drinking history in terms of the basic situation, the higher proportion of larger age group when checking into aspects of laboratory was detected Albumin (A) lower, alkaline phosphatase (ALP), glutamyl transferase phthalate (GGT) higher platelet (PTL) is low, the same in terms of prothrombin time (PT) is longer, to follow-up As of the date of HBVDNA higher viral load. Research carried out from survival analysis, based on different levels of the virus HBVDNA packet is selected, there is no significant difference in the incidence of cirrhosis of the patients of this group (X2=2.20, P=0.53); and to follow-up ended, it can be concluded HBVDNA The higher the load, the greater the proportion of patients with cirrhosis (X2=11.7, P=0.0187). In contrast, as of the time of follow-up, the probability of HBVDNA viral load was less in patients with liver cirrhosis is low.3 According to Cox regression analysis to detect the proportional hazards model, follow-up as of the time HBVDNA viral load levels in patients [hazard ratio was 1.896 (95% CI 1.244-2.896, P= 0.003))], were enrolled at the liver fibrosis staging [hazard ratio 1.958 (95% confidence interval 1.138-3.221, P=0.014)], HBeAg-negative [hazard ratio 8.975 ((95% confidence interval 1.655-48.661, P=0.009)], and GCT [hazard ratio 1.004 (95% CI 1.003-1.010, P=0.011).] to predict progression of chronic hepatitis B as an independent risk factor for cirrhosis,Inconclusion:1, HBVDNA viral load levels in patients enrolled when liver tissue fibrosis, e antigen negative rate and phthalate-glutamyl transferase (GCT) is an independent factor of cirrhosis develop into chronic hepatitis.2, Serum HBVDNA viral load levels in patients with chronic hepatitis and cirrhosis of the liver is closely related to whether or not progress. It requires regular follow-up of patients HBVDNA load levels to predict whether a patient will occur cirrhosis important. Thus we can conclude that effective antiretroviral therapy can reduce the level of HBVDNA viral load in patients with chronic hepatitis B, which can reduce the incidence of patients at risk of liver cirrhosis. |
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