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预防医学  2021, Vol. 33 Issue (5): 433-437    DOI: 10.19485/j.cnki.issn2096-5087.2021.05.001
  论著 本期目录 | 过刊浏览 | 高级检索 |
乙肝患者肝癌诊断前规范筛查的影响因素分析
揭彬1, 白春花2, 毕华强3, 邱琰3
1.陆军军医大学(第三军医大学)医学心理系军人发展心理学教研室,重庆 400038;
2.陆军军医大学西南医院超声科;
3.陆军军医大学西南医院肝胆外科
Factors associated with adherence to screening before diagnosis of hepatocellular carcinoma related to chronic hepatitis B
JIE Bin*, BAI Chunhua, BI Huaqiang, QIU Yan
*Department of Military Developmental Psychology, School of Psychology, Army Medical University (Third Military Medical University), Chongqing 400038, China
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摘要 目的 分析乙肝患者肝癌诊断前5年规范筛查的影响因素,为提高肝癌规范筛查率提供依据。方法 选取2016年6月—2018年4月陆军军医大学西南医院肝胆外科首次诊断为肝癌且有5年以上慢性乙肝病史的患者为研究对象,采用自行设计的调查表收集患者的人口学信息、健康状况、治疗情况和诊断前5年肝癌筛查资料;采用多因素Logistic回归模型分析肝癌规范筛查的影响因素。结果 纳入肝癌患者420例,诊断前5年坚持规范筛查140例,占33.33%;不规范筛查124例,占29.53%;未筛查156例,占37.14%。规范筛查患者诊断为早期肝癌的比例为77.14%,高于不规范筛查患者的35.48%和未筛查患者的12.82%(P<0.05)。多因素Logistic回归分析结果显示,高中及以上文化程度(OR=2.346,95%CI:1.370~4.017)、有肝癌家族史(OR=2.795,95%CI:1.457~5.362)、有慢性病史(OR=3.860,95%CI:2.052~7.262)、接受抗乙肝病毒药物治疗(OR=17.816,95%CI:9.702~32.716)和专科就诊(OR=8.332,95%CI:1.588~43.710)是肝癌规范筛查的影响因素。结论 肝癌患者诊断前5年规范筛查有利于肝癌的早期发现,但乙肝患者肝癌规范筛查率较低。文化程度、肝癌家族史、健康状况及治疗情况可能影响肝癌规范筛查。
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揭彬
白春花
毕华强
邱琰
关键词 慢性乙肝肝癌筛查影响因素    
AbstractObjective To investigate the factors associated with the patient's adherence to screening in the five years before the diagnosis of hepatocellular carcinoma (HCC) related to chronic hepatitis B ( CHB ), so as to provide reference for improving the screening rate. Methods From June 2016 to April 2018, the patients with newly diagnosed HCC and a history of CHB for more than five years in Southwest Hospital in Chongqing were interviewed. The information about socio-demographic characteristics, health status, medical care and HCC screening in the past five years were collected. A multivariate logistic regression model was used to analyze the factors associated with adherence to screening. Results Among 420 participants, 140 ( 33.33% ) adhered to HCC screening, 124 ( 29.53% ) had irregular/incomplete screening, while 156 ( 37.14% ) never had screening. The proportion of early-stage HCC at diagnosis was significantly higher in patients who adhered to screening ( 77.14% ) than that in patients who had irregular/incomplete screening (35.48%) or no screening ( 12.82% ) and the differences were statistically significant ( P<0.05 ). The multivariate analysis demonstrated that five factors were significantly associated with patient's adherence to screening, including education level of high school and above ( OR=2.346, 95%CI: 1.370-4.017), family history of HCC ( OR=2.795, 95%CI: 1.457-5.362 ), history of chronic diseases ( OR=3.860, 95%CI: 2.052-7.262), acceptance of antiviral therapy ( OR=17.816, 95%CI: 9.702-32.716 ) and specialized clinic visits ( OR=8.332, 95%CI: 1.588-43.710 ). Conclusions Adherence to screening is conducive to the early detection of HCC, but the screening rate is low in the patients with CHB. Education level, history of HCC, health status and medical status are significantly related to screening adherence.
Key wordschronic hepatitis B    hepatocellular carcinoma    screening    associated factor
收稿日期: 2020-11-06      出版日期: 2021-05-12
ZTFLH:  R512.62  
基金资助:国家社会科学基金(16BSH096)
通信作者: 毕华强,E-mail:psycho_med@sina.com   
作者简介: 揭彬,博士,讲师,主要从事行为医学及健康心理学研究工作
引用本文:   
揭彬, 白春花, 毕华强, 邱琰. 乙肝患者肝癌诊断前规范筛查的影响因素分析[J]. 预防医学, 2021, 33(5): 433-437.
JIE Bin, BAI Chunhua, BI Huaqiang, QIU Yan. Factors associated with adherence to screening before diagnosis of hepatocellular carcinoma related to chronic hepatitis B. Preventive Medicine, 2021, 33(5): 433-437.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2021.05.001      或      http://www.zjyfyxzz.com/CN/Y2021/V33/I5/433
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