原发性肝癌发生感染性并发症的危险因素分析

刘洪金; 鲍春梅; 白文林; 李因茵; 荣光华; 陆荫英; 陈艳; 刘泽; 程家敏; 曾珍

doi:10.3969/j.issn.1001-5256.2018.05.021

原发性肝癌发生感染性并发症的危险因素分析

DOI: 10.3969/j.issn.1001-5256.2018.05.021

1. 中国人民解放军第三〇二医院肝脏肿瘤研究与诊疗中心
2. 中国人民解放军第三〇二医院临床医学检验中心

基金项目:

国家自然科学基金资助项目(813722481012487)；军队十二五项目(CWS12J024)；

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2017-11-29
- 出版日期: 2018-05-20

Risk factors for infectious complications in primary liver cancer

Liver Tumor Research and Treatment Center, 302 Hospital of PLA

Research funding:

摘要

摘要: 目的探究原发性肝癌发生感染性并发症的相关危险因素。方法收集2016年2月-2017年2月解放军第三〇二医院肝脏肿瘤研究与诊疗中心收治的3034例原发性肝癌患者的临床资料,其中发生感染性并发症297例,未发生感染性并发症2737例,分别随机抽取153例感染患者、46例非感染患者为感染组、非感染组。感染组中男133例,女20例,年龄3475岁,平均（56.41±6.69）岁;非感染组男37例,女9例,年龄4774岁,平均（57.52±11.12）岁。分析可疑危险因素与原发性肝癌发生感染性并发症的关系。计量资料符合正态性分布的数据2组间比较采用t检验,偏态分布的数据2组间比较采用Wilcoxon秩和检验;计数资料2组间比较采用χ2检验,危险因素分析采用多因素logistic回归分析。结果多因素分析结果显示,患者年龄≤60岁（OR=5.048,P<0.001）、乙型肝炎病程长（OR=2.446,P=0.035）、HBV DNA阳性（OR=2.618,P=0.005）、Child-Pugh评分高（OR=0.167、P=0.004）、Alb水平低（...
- 肝肿瘤 /
- 感染 /
- 危险因素 /
- logistic模型
Abstract: Objective To investigate the risk factors for infectious complications in patients with primary liver cancer. Methods A retrospective analysis was performed for the clinical data of 3034 patients with primary liver cancer who were admitted to 302 Hospital of PLA from February 2016 to February 2017, and among these patients, 297 experienced infectious complications and 2737 did not experience infectious complications; 153 patients with infectious complications were enrolled as infection group, and 46 without infectious complications were enrolled as non-infection group. There were 133 male and 20 female patients aged 34-75 years ( mean 56. 41 ± 6. 69 years) in the infection group, and 37 male and 9 female patients aged 47-74 years ( mean 57. 52 ± 11. 12 years) in the non-infection group. The association between possible risk factors and infectious complications in patients with primary liver cancer was analyzed. The t test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank sum test was used for comparison of continuous data with skewed distribution between two groups. The chi-square test was used for univariate analysis, and the multivariate logistic regression analysis was used for multivariate analysis. Results The multivariate logistic regression analysis showed that age ≤60 years ( OR = 5. 048, P <0. 001) , long course of hepatitis B and liver cancer ( OR = 2. 446, P = 0. 035, OR = 0. 433, P = 0. 016) , high HBV DNA ( OR = 2. 618, P =0. 005) , high white blood cell count ( OR = 1. 170, P = 0. 001) , high levels of alpha-fetoprotein ( AFP) ( OR = 0. 470, P = 0. 032) , alkaline phosphatase ( OR = 1. 004, P = 0. 004) , and gamma-glutamyl transpeptidase ( OR = 1. 004, P = 0. 006) , high Child-Pugh score ( OR = 0. 167, P = 0. 004) , low albumin ( OR = 0. 999, P < 0. 001) and cholinesterase ( OR = 0. 834, P < 0. 001) , long prothrombin time ( OR = 1. 299, P = 0. 007) , large maximum tumor diameter ( OR = 0. 389, P < 0. 005) , and presence of portal vein tumor thrombus ( OR =2. 378, P = 0. 018) were independent risk factors for infection in patients with primary liver cancer and HBV infection ( all P < 0. 05) . Conclusion Infection in patients with primary liver cancer is associated with risk factors including age of onset, course of hepatitis B and liver cancer, tumor diameter, portal vein tumor thrombus, HBV DNA and AFP levels, and liver function, which should be taken seriously in clinical practice. Active measures should be adopted to reduce infectious complications.
- liver neoplasms /
- infection /
- risk factors /
- logistic models

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