Xu Biao, Hu Dechang, Daniel Rosenberg, Jiang Qingwu, Lin Ximin, Lu Jialiang, Li Xuliang
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.
Zhonghua Nei Ke Za Zhi. 2002 Jun;41(6):384-7.
To describe the natural history of chronic hepatitis Beta in patients with chronic hepatitis Beta (CHB) in Shanghai, China.
322 cases with biopsy-proven CHB diagnosed from 1981 to 1993 were retrospectively studied. Medical records since the original diagnosis were reviewed and final examination was performed on those who were still living. Survival analysis including life table, Kaplan-Meier method and Log-Rank test was applied to compare the survival rates, and un-happen rates of decompensated cirrhosis and hepatocellular carcinoma between the groups with compensated cirrhosis and without cirrhosis at the original diagnosis. Standardized mortality ratio (SMR) was calculated to reflect the death risks from total death, hepatic disease death and liver cancer death.
For CHB without cirrhosis group, the incidence of decompensated cirrhosis and hepatocellular carcinoma were 6.7 per thousand person-year and 2.8 per thousand person-year,respectively. The mortality was 7.6 per thousand person-year. The 5-, 10-, 15- year survival rates were 95.9%, 93.0% and 87.9%, respectively. The 5-, 10-, 15-year decompensated cirrhosis un-happen rates were 97.1%, 95.4% and 88.9%, respectively. The SMRs of total death, liver cancer death and hepatic diseases death were 2.50, 9.73 and 80.38, respectively. For CHB with compensated cirrhosis group, the incidence of decompensated cirrhosis and hepatocellular carcinoma were 35.6 per thousand person-year and 8.2 per thousand person-year, respectively. The mortality was 35.2 per thousand person-year. The 5-, 10-, 15- year survival rates were 85.3%, 69.0% and 55.8%, respectively. The 5-, 10-, 15-year decompensated cirrhosis un-happen rates were 82.0%, 63.8%, and 58.7%, respectively. The SMRs of total death, liver cancer death and hepatic diseases death were 8.09, 30.30 and 312.50, respectively.
CHB with compensated cirrhosis group had a significantly lower survival rates and lower un-happen rates of decompensated cirrhosis as compared with CHB without cirrho s is group through Log-Rank tests. Both groups had remarkable high SMRs of total death, liver cancer death and hepatic disease death.
描述中国上海慢性乙型肝炎（CHB）患者慢性乙型肝炎的自然史。
对1981年至1993年经活检证实的322例CHB患者进行回顾性研究。回顾自初次诊断以来的病历，并对仍在世的患者进行末次检查。采用生存分析，包括生命表、Kaplan-Meier法和Log-Rank检验，比较初次诊断时代偿期肝硬化组和无肝硬化组的生存率、失代偿期肝硬化和肝细胞癌的未发生率。计算标准化死亡比（SMR）以反映全因死亡、肝病死亡和肝癌死亡的死亡风险。
对于无肝硬化的CHB组，失代偿期肝硬化和肝细胞癌的发生率分别为每千人年6.7例和每千人年2.8例。死亡率为每千人年7.6例。5年、10年、15年生存率分别为95.9%、93.0%和87.9%。5年、10年、15年失代偿期肝硬化未发生率分别为97.1%、95.4%和88.9%。全因死亡、肝癌死亡和肝病死亡的SMR分别为2.50、9.73和80.38。对于代偿期肝硬化的CHB组，失代偿期肝硬化和肝细胞癌的发生率分别为每千人年35.6例和每千人年8.2例。死亡率为每千人年35.2例。5年、10年、15年生存率分别为85.3%、69.0%和55.8%。5年、10年、15年失代偿期肝硬化未发生率分别为82.0%、63.8%和58.7%。全因死亡、肝癌死亡和肝病死亡的SMR分别为8.09、30.30和312.50。
通过Log-Rank检验，与无肝硬化的CHB组相比（代偿期）肝硬化的CHB组生存率显著降低，失代偿期肝硬化的未发生率也较低。两组全因死亡、肝癌死亡和肝病死亡的SMR均显著较高。
