论文部分内容阅读
采用配比多级暴露水平分析方法，在１００例原发性肝细胞癌（ＨＣＣ）患者及经１１配比的非ＨＣＣ患者中进行了乙型肝炎病毒（ＨＢＶ）和丙型肝炎病毒（ＨＣＶ）感染的不同暴露水平与ＨＣＣ关系的病例对照研究，重点评价二者在ＨＣＣ发病中的协同作用。结果为：血清ＨＢｓＡｇ（－）、抗ＨＣＶ（＋）的ＯＲ值为３．４０３，ＨＢｓＡｇ（＋）、抗ＨＣＶ（－）的ＯＲ值为９．０７８，ＨＢｓＡｇ（＋）、抗ＨＣＶ（＋）的ＯＲ值为３０．８７（Ｐ均＜０．０５）。提示ＨＣＶ感染是ＨＣＣ发生的危险因素。但比较起来，ＨＢｓＡｇ（＋）者的危险性要大于抗ＨＣＶ（＋）者的危险性。而ＨＢＶ和ＨＣＶ重叠感染的超额危险（３０．８７－１＝２９．８７）大于ＨＢＶ和ＨＣＶ各独立感染时的超额危险之和（３．４０３－１）＋（９．０７８－１）＝１０．４８１），说明二者在ＨＣＣ发病中起协同作用。经对数线性趋势检验，各暴露水平与ＨＣＣ的联系强度间存在有极显著的剂量反应关系（Ｐ＜０．００１）。
Hepatitis B virus (HBV) and Hepatitis C virus (HCV) were tested in 100 patients with primary hepatocellular carcinoma (HCC) and 11 patients with non-HCC using proportional multistage exposure analysis. Case-control study of the relationship between different exposure levels of HCC and infection, with a focus on the synergy between the two in the pathogenesis of HCC. The OR of serum HBsAg (-) and antiHCV (+) was 3.403, and the OR of HBsAg (+) and antiHCV (-) was 9.078, HBsAg The OR of (+) was 30.87 (all P <0.05). It is suggested that HCV infection is a risk factor for HCC. However, in comparison, the risk of HBsAg (+) is greater than that of anti-HCV (+). The excess risk of overlapping HBV and HCV infections (30.87-1 = 29.87) was greater than the sum of excess risk (3.403-1) + (9.078-1) = 10 when HBV and HCV were independently infected .481), indicating that both play a synergistic role in the pathogenesis of HCC. Log-linear trend test showed that there was an extremely significant dose-response relationship between each exposure level and the contact intensity of HCC (P <0.001).