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波兰丙型肝炎慢性感染相关的肝外表现。

Extrahepatic manifestations associated with chronic hepatitis C infections in Poland.

机构信息

Department of Infectious Diseases, Provincial Hospital, Kielce, Poland.

出版信息

Adv Med Sci. 2010;55(1):67-73. doi: 10.2478/v10039-010-0009-4.

Abstract

PURPOSE

To assess the prevalence and predictive factors of extrahepatic manifestation (EM) in patients with chronic hepatitis C (CHC) infection in Poland.

MATERIAL AND METHODS

340 consecutive patients (mean age: 42 years) with untreated CHC were studied between 2000 and 2006. The HCV infection was defined by positive serology and serum HCV RNA. The inflammation grade and fibrosis stage were assessed according to Ishak. Demographic, laboratory and liver biopsy data were collected. The patients with liver cirrhosis, concomitant HBV or HIV infection, autoimmune liver diseases and alcohol abusers were excluded from the analysis.

RESULTS

210 patients with CHC (61.7%) presented at least 1 extrahepatic manifestation, including mixed cryoglobulinemia (37.1%), thrombocytopenia (27.6%), thyroid autoimmunity (16.2%), dermatological disorders (4.1%) and type 2 diabetes (4.1%). Other EM such as the sicca syndrome, nephropathy, polyneuropathy and B-cell lymphoma were observed in single cases. In multivariate analysis lower platelet count was found as a predictive factor of EM in patients with CHC.

CONCLUSIONS

The majority of patients with CHC, living in Poland, have EM, of which cryoglobulinemia, thrombocytopenia, thyroid autoimmunity, dermatological disorders and type 2 diabetes are most common. Through the multivariate analysis the lower platelet predicts extrahepatic manifestations associated with chronic hepatitis C.

摘要

目的

评估波兰慢性丙型肝炎(CHC)感染患者的肝外表现(EM)的流行率和预测因素。

材料与方法

2000 年至 2006 年间,研究了 340 例未经治疗的 CHC 连续患者(平均年龄:42 岁)。HCV 感染通过阳性血清学和血清 HCV RNA 定义。炎症程度和纤维化阶段根据 Ishak 进行评估。收集了人口统计学、实验室和肝活检数据。排除了肝硬化、合并 HBV 或 HIV 感染、自身免疫性肝病和酗酒者进行分析。

结果

210 例 CHC 患者(61.7%)至少存在 1 种肝外表现,包括混合性冷球蛋白血症(37.1%)、血小板减少症(27.6%)、甲状腺自身免疫(16.2%)、皮肤病(4.1%)和 2 型糖尿病(4.1%)。其他 EM,如干燥综合征、肾病、多发性神经病和 B 细胞淋巴瘤,仅在单个病例中观察到。在多变量分析中,发现血小板计数较低是 CHC 患者 EM 的预测因素。

结论

波兰大多数 CHC 患者存在 EM,其中冷球蛋白血症、血小板减少症、甲状腺自身免疫、皮肤病和 2 型糖尿病最常见。通过多变量分析,较低的血小板预示着与慢性丙型肝炎相关的肝外表现。

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