摘要【目的】研究丙型肝炎病毒(HCV)直接抗病毒药物(DAA)抗病毒干预获得持续病毒学应答(SVR)后发生肝细胞肝癌(HCC)患者的临床特征。【方法】纳入本院130例HCV感染患者作为研究对象,所有患者均接受HCV抗病毒治疗,记录SVR情况。出院后随访记录HCC发生率。根据是否发生HCC,将获得SVR的患者分为观察组(发生HCC)和对照组(未发生HCC)。比较两组患者基本资料和临床病理特点,采用Cox多因素风险模型探讨经HCV抗病毒干预后获得SVR患者发生HCC的高危因素。【结果】130例患者中98例达到SVR效果,SVR率为75.38%,在98例患者中,随访期间共发生HCC 6例,发生率6.12%。不同预后患者DAA治疗情况、肝脏状态、谷草转氨酶(AST)、谷丙转氨酶(ALT)及甲胎蛋白(AFP)水平比较差异均有显著性( P <0.05)。Cox多因素风险分析显示ADD治疗情况、肝脏状态及AFP水平是HCV抗病毒治疗获得SVR的患者后发生HCC的危险因素(均 P <0.05)。【结论】对于HCV抗病毒干预治疗后达到SVR的患者,患者DAA治疗情况、肝脏状态及AFP水平是影响患者发生HCC的独立因素。
Abstract：【Objective】To investigate the clinical characteristics of hepatitis C virus (HCV) treated with direct-acting antivirals(DAA) patients with hepatocellular carcinoma (HCC) during the sustained virological response (SVR) after antiviral intervention. 【Methods】 A total of 130 patients with HCV infection in our hospital were recruited in the study. All patients were received HCV antiviral therapy and the SVR rate was recorded. The incidence of HCC were followed up after discharge. According to the occurrence of HCC, patients with SVR were further divided into the observation group (occurrence of HCC) and the control group (no occurrence of HCC).The basic data and clinicopathological characteristics were compared between the two groups. The Cox multivariate risk model was used to explore the high risk factors of HCC in patients with SVR after HCV antiviral intervention. 【Results】Among 130 patients with HCV,98 required SVR after HCV antiviral intervention. The SVR rate was 75.38%.There were 6 cases of HCC occurred during the follow-up period, which was 6.12% (6/98).There were significant differences in direct antiviral drugs (DAA) treatment, liver status, AST, ALT and AFP levels among patients with different prognosis, the difference were statistically significant ( P <0.05).The Cox multivariate risk analysis showed that the DAA treatment, liver status and AFP level were the risk factors for HCC after SVR ( P <0.05). 【Conclusion】 The DAA treatment, liver status and AFP level are the independent factors, which affect the occurrence of HCC for the patients with SVR after antiviral therapy.
刘冬宇, 白劼, 张文华, 郝艳霞. 丙型肝炎病毒患者抗病毒干预持续应答后发生肝细胞肝癌的临床特征*[J]. 医学临床研究, 2021, 38(3): 356-358.
LIU Dong-yu, BAI Jie, ZHANG Wen-hua, et al. Clinical Analysis of Hepatitis C Virus Patients with Hepatocellular Carcinoma during Sustained Virological Response after Antiviral Intervention. JOURNAL OF CLINICAL RESEARCH, 2021, 38(3): 356-358.
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2021, Vol. 38 
