| 摘要: |
| ［摘要］ 目的 探讨非酒精性脂肪性肝病（NAFLD）伴发原发性肝癌（HCC）的发病率、临床特征和危险因素。方法 采用回顾性分析的方法，选取该院住院确诊的1 092例HCC患者，参照2006-02中华医学会肝脏病分会脂肪肝和酒精性肝病学组《非酒精性脂肪性肝病诊疗指南》中关于NAFLD的临床诊断标准，从HCC患者中遴选出符合NAFLD诊断标准的72例患者，分析NAFLD相关HCC的发病率、临床表现及生化指标、影像学特征、生存率及影响预后的危险因素。结果 NAFLD伴发HCC患者共72例，占HCC患者的6.6%，年龄（60.52±10.21）岁，伴有2型糖尿病（T2DM）者35例，占48.6%（35/72），体重指数（BMI）≥26 kg/m2者28例，占38.9%（28/72）,伴有高血压病者34例，占47.2%（34/72）。主要临床表现无明显特征性。其生存情况：随访NAFLD伴发HCC病例72例，死亡53例，1、2、3年生存率分别为68.47%、40.26%、30.52%。单因素分析BMI、T2DM、高血压病、谷丙转氨酶（ALT）、总胆红素（TBIL）、直接胆红素（DBIL）、谷氨酰转移酶（GGT）、胆碱酯酶（CHE）对NAFLD伴发HCC生存率比较差异有统计学意义（P<0.05），可能是影响预后的危险因素。多因素分析显示BMI、T2DM是影响预后的独立危险因素。结论 NAFLD是HCC发生的原因之一，肥胖、T2DM是影响NAFLD伴发HCC预后的独立危险因素。 |
| 关键词: 非酒精性脂肪性肝病 原发性肝癌 临床特征 危险因素 |
| DOI：10.3969/j.issn.1674-3806.2013.08.14 |
| 分类号:R 735.7 |
| 基金项目: |
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| Correlation study of nonalcoholic fatty liver disease and primary hepatocellular carcinoma |
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TIAN Jing-hui, TANG Yan-xia
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Department of Internal Medicine, Central Hospital of Jiaozuo Coal Industry Group,Henan 454100, China
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| Abstract: |
| ［Abstract］ Objective To investigate the incidence, clinical characteristics, risk factors of nonalcoholic fatty liver disease(NAFLD) with primary hepatocellular carcinoma(HCC).Methods A retrospective analysis was performed.From 1 092 hospitalized patients with HCC, according to “clinical diagnostic criteria for nonalcoholic fatty liver disease in nonalcoholic fatty liver disease diagnosis and treatment guidelines” of fatty liver and alcoholic liver disease study group of Chinese Liver disease Association,72 HCC patients were selected who met the diagnostic criteria of NAFLD.In 72 patients with NAFLD with HCC, incidence, clinical and biochemical indexes, imaging characteristics, survival rate and the risk factors influencing the prognosis were analyzed.Results In 1 092 HCC patients, there were 72 patients with NAFLD, accounted for 6.6%, average age (60.52±10.21);with type 2 diabetes mellitus in 35 cases，accounted for 48.6%(35/72);body mass index ≥26 kg/m2 in 28 cases, accounted for 38.9%(28/72);hypertension 34 cases, accounted for 47.2%(34/72). The main clinical manifestations had no obvious characteristic.In follow-up of 72 patients with NAFLD with primary HCC, 53 cases died; 1, 2, 3 year survival rates were 68.47%, 40.26%, 30.52%. BMI, T2DM, hypertension, ALT, TBIL, DBIL, GGT, CHE on survival rate of NAFLD patients with HCC were statistically significant in univariate analysis, may be the risk factors influencing the prognosis. Multivariate analysis showed that BMI, T2DM were independent prognostic factors. Conclusion NAFLD is the primary reason for the occurrence of HCC.Obesity, T2DM are independent risk factors influencing the prognosis of patients with NAFLD with HCC. |
| Key words: Nonalcoholic fatty liver disease Hepatocellular carcinoma(HCC) Clinical characteristics Risk factor |
