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CID:糖尿病增加慢性乙型肝炎患者肝硬化及失代偿风险

2013-09-29 佚名 丁香园

目前尚不清楚糖尿病对慢性乙型肝炎(CHB)患者肝硬化及失代偿的影响以及它们之间的时态关联情况。因此,来自我国台湾国泰综合医院医疗中心的医学博士高嘉宏等人展开了一项全民队列研究,研究结果在线发表于2013年9月的《临床感染性疾病》(Clinical Infectious Diseases)杂志上。研究发现,糖尿病合并CHB患者出现肝硬化及失代偿的风险增加。【原文下载】

目前尚不清楚糖尿病对慢性乙型肝炎(CHB)患者肝硬化及失代偿的影响以及它们之间的时态关联情况。因此,来自我国台湾国泰综合医院医疗中心的医学博士高嘉宏等人展开了一项全民队列研究,研究结果在线发表于2013年9月的《临床感染性疾病》(Clinical Infectious Diseases)杂志上。研究发现,糖尿病合并CHB患者出现肝硬化及失代偿的风险增加。【原文下载】

研究人员利用台湾全民健康保险研究数据库的资料开展了一项全民队列研究,该数据库涵盖了台湾99%以上人口的资料。在经随机抽样所获得的一百万名参试者中,有14,523名成年参试者在1997-2009年间被诊断为CHB患者。研究人员将CHB患者中于1998-2001年期间(而非1996-1997年)新确诊罹患糖尿病且每年至少进行2次门诊的患者定义为新发糖尿病患者。

CHB合并新发糖尿病患者队列共有351名参试者,而非糖尿病队列则为7,886名参试者,自确诊为糖尿病之日起或自2000年起开始随访工作,直至参试者出现肝硬化或失代偿,撤销保险或至2009年9月份结束随访。

研究结果如下:Kaplan-Meier生存分析表明,与未患糖尿病的CHB患者相比,合并新发糖尿病患者肝硬化和失代偿性肝硬化的累计发病率显著增加。根据Cox比例风险模型校正年龄、性别、CHB治疗、肝细胞癌和合并症指数后,糖尿病仍然是肝硬化及失代偿的独立预测因素。

这一基于人群的大规模队列研究表明,CHB患者出现新发糖尿病和肝硬化及失代偿之间存在时态关联,糖尿病的发生要早于肝硬化及失代偿。随着时间的增加,糖尿病合并CHB患者出现肝硬化及失代偿的风险也相应增加。

原文下载

Huang YW, Wang TC, Lin SC, Chang HY, Chen DS, Hu JT, Yang SS, Kao JH.Increased risk of cirrhosis and its decompensation in chronic hepatitis B patients with new onset diabetes: A nationwide cohort study.Clin Infect Dis. 2013 Sep 18.

 

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