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丙型肝炎感染作为高血压和心血管疾病的危险因素:一项EpiTer多中心研究

Hepatitis C Infection as a Risk Factor for Hypertension and Cardiovascular Diseases: An EpiTer Multicenter Study.

作者信息

Rajewski Paweł, Zarębska-Michaluk Dorota, Janczewska Ewa, Gietka Andrzej, Mazur Włodzimierz, Tudrujek-Zdunek Magdalena, Tomasiewicz Krzysztof, Belica-Wdowik Teresa, Baka-Ćwierz Barbara, Dybowska Dorota, Halota Waldemar, Lorenc Beata, Sitko Marek, Garlicki Aleksander, Berak Hanna, Horban Andrzej, Orłowska Iwona, Simon Krzysztof, Socha Łukasz, Wawrzynowicz-Syczewska Marta, Jaroszewicz Jerzy, Deroń Zbigniew, Czauż-Andrzejuk Agnieszka, Citko Jolanta, Krygier Rafał, Piekarska Anna, Laurans Łukasz, Dobracki Witold, Białkowska Jolanta, Tronina Olga, Wietlicka-Piszcz Magdalena, Pawłowska Małgorzata, Flisiak Robert

机构信息

Department of Internal and Infectious Diseases, Provincial Infectious Disease Hospital, 85-030 Bydgoszcz, Poland.

Department of Infectious Diseases, Voivodship Hospital and Jan Kochanowski University, 25-369 Kielce, Poland.

出版信息

J Clin Med. 2022 Sep 1;11(17):5193. doi: 10.3390/jcm11175193.

Abstract

Hepatitis C infection is one of the main reasons for liver cirrhosis and hepatocellular carcinoma. In recent years, more and more is being heard about extrahepatic manifestations of the hepatitis C infection including its possible influence on the development of hypertension and cardiovascular diseases. In the given work, the frequency analysis of the incidence of hypertension and cardiovascular diseases among 2898 HCV-infected patients treated in Poland and the assessment of their relevance to the HCV genotype and the progression of liver fibrosis can be found. The prevalence of hypertension in the group of analyzed patients was 39% and was significantly associated with old age (OR = 1.08 (1.07-1.08)) and female sex, as well as the progression of liver fibrosis (OR = 1.54 (1.29-1.85)). Hypertension was found in 47.6% of patients with F4 fibrosis, 42.1% of patients with F3 fibrosis, and 25% of patients with F1 fibrosis. The incidence of cardiovascular disease in the studied group of patients was as follows: all incidents, 131 (4.52%); including ischemic heart disease 104, (3.95%); stroke, 2 (0.07%); atherosclerosis, 21 (0.72%); and aneurysms, 4 (0.14%). The obtained results prove that the prevalence of cardiovascular diseases is significantly associated with the advanced age of patients and the progression of liver fibrosis. The relevance of sex and the HCV genotype to the prevalence frequency of cardiovascular diseases in the study group has not been proven. This being the case, no differences in the frequency of their incidence depending on the HCV genotype, including genotype 3, was found. Hepatitis C infection as a non-classical risk factor for cardiovascular disease and hypertension does require further studying.

摘要

丙型肝炎感染是肝硬化和肝细胞癌的主要原因之一。近年来,越来越多关于丙型肝炎感染肝外表现的报道出现,包括其对高血压和心血管疾病发展的可能影响。在这项特定研究中,可以找到对波兰2898名接受治疗的丙型肝炎病毒(HCV)感染患者中高血压和心血管疾病发病率的频率分析,以及对它们与HCV基因型和肝纤维化进展相关性的评估。在分析的患者组中,高血压患病率为39%,并且与老年(比值比[OR]=1.08(1.07 - 1.08))、女性性别以及肝纤维化进展显著相关(OR = 1.54(1.29 - 1.85))。在F4纤维化患者中,47.6%患有高血压;F3纤维化患者中,42.1%患有高血压;F1纤维化患者中,25%患有高血压。研究组患者心血管疾病的发病率如下:所有病例,131例(4.52%);包括缺血性心脏病104例(3.95%);中风2例(0.07%);动脉粥样硬化21例(0.72%);动脉瘤4例(0.14%)。所得结果证明,心血管疾病的患病率与患者的高龄和肝纤维化进展显著相关。在该研究组中,性别和HCV基因型与心血管疾病患病率频率的相关性尚未得到证实。在这种情况下,未发现其发病率频率因HCV基因型(包括3型)而异。丙型肝炎感染作为心血管疾病和高血压的非经典危险因素确实需要进一步研究。

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