摘要
目的分析慢性乙型肝炎(CHB)患者肝细胞癌(HCC)监测依从性的影响因素。方法选取2012年6月—2016年12月参加湖北省中医院临床研究且结束临床研究时间>4年的CHB患者,于2020年9月—2021年12月对其进行问卷随访调查,以至少每隔6个月进行1次HCC早期筛查作为定期监测,分析HCC高危人群近4年定期监测的依从性及其影响因素。非正态分布计量资料两组间比较采用Wilcoxon秩和检验。计数资料组间比较采用χ^(2)检验。采用多因素Logistic回归分析CHB患者HCC定期监测依从性的影响因素。结果共纳入CHB患者223例,定期进行HCC监测CHB患者占30.94%(69/223)。单因素分析结果显示:年龄(χ^(2)=11.940,P=0.003)、长期接受健康宣传教育(χ^(2)=32.066,P<0.001)、抗病毒药物服用情况(χ^(2)=10.004,P=0.002)、HBV DNA(χ^(2)=12.365,P<0.001)与患者定期HCC监测依从性有关。多因素Logistic回归分析结果显示:年龄≥60岁(OR=0.197,95%CI:0.050~0.777,P=0.020)和长期接受健康宣传教育(OR=4.810,95%CI:2.219~10.429,P<0.001)是CHB患者HCC监测依从性的独立影响因素。结论CHB患者HCC定期监测总体依从性较差。其中,年龄≥60岁的CHB患者HCC定期监测依从性较其他年龄段较差,长期接受健康教育的患者HCC定期监测依从性较好。
Objective To investigate the influencing factors for compliance with hepatocellular carcinoma(HCC)surveillance in patients with chronic hepatitis B(CHB).Methods The CHB patients who participated in the clinical study of Hubei Provincial Hospital of Traditional Chinese Medicine from June 2012 to December 2016 and had an interval of>4 years from the end of the clinical study were enrolled,and a questionnaire follow-up survey was conducted from September 2020 to December 2021.Early screening for HCC was conducted at least every 6 months as regular surveillance,and compliance with 4-year regular surveillance and related influencing factors were analyzed in the population at a high risk of HCC.The Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups,and the chi-square test was used for comparison of categorical data between groups.A multivariate Logistic regression analysis was used to investigate the influencing factors for regular HCC surveillance in CHB patients.Results A total of 223 CHB patients were enrolled,and 30.94%(69/223)of these CHB patients underwent regular HCC surveillance.The univariate analysis showed that age(χ^(2)=11.940,P=0.003),long-term health education(χ^(2)=32.066,P<0.001),use of antiviral drugs(χ^(2)=10.004,P=0.002),and HBV DNA(χ^(2)=12.365,P<0.001)were associated with the compliance with regular HCC surveillance in patients.The multivariate Logistic regression analysis showed that age≥60 years(odds ratio[OR]=0.197,95%confidence interval[CI]:0.050-0.777,P=0.020)and long-term health education(OR=4.810,95%CI:2.219-10.429,P<0.001)were independent influencing factors for compliance with HCC surveillance in CHB patients.Conclusion There is poor overall compliance with regular HCC surveillance in CHB patients.CHB patients aged≥60 years had poorer compliance with regular HCC surveillance than the other age groups,and patients receiving long-term health education tend to have good compliance with regular HCC surveillance.
作者
任朦
陶军秀
李紫明
郝琦
杨益
施雨峰
刘逸藩
许悦
郑通通
李晓东
REN Meng;TAO Junxiu;LI Ziming;HAO Qi;YANG Yi;SHI Yufeng;LIU Yifan;XU Yue;ZHENG Tongtong;LI Xiaodong(College of Clinical Chinese Medicine,Hubei University of Chinese Medicine,Wuhan 430065,China;Hubei Key Laboratory of Theoretical and Applied Research of Liver and Kidney in Traditional Chinese Medicine,Department of Hepatology,Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430061,China;Hubei Academy of Chinese Medicine,Wuhan 430074,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2023年第9期2096-2102,共7页
Journal of Clinical Hepatology
基金
“十三五”重大科技专项(2018ZX10302204)
湖北省公共卫生领军人才培养计划(鄂卫通[2021]73号)。
关键词
乙型肝炎
慢性
癌
肝细胞
病人依从
Hepatitis B,Chronic
Carcinoma,Hepatocellular
Patient Compliance
作者简介
通信作者:李晓东,lixiaodong555@126.com(ORCID:0000-0002-6406-9416)。
