Investigation and analysis of HBV infection and related cirrhosis in a certain area / 公共卫生与预防医学

Objective To investigate and analyze the incidence of hepatitis B virus (HBV) infection and related cirrhosis in a certain area. Methods A retrospective investigation was performed on 365 patients with HBV infection in a certain area from October 2018 to October 2020. The relevant data of the patients and the incidence of HBV infection-related cirrhosis were analyzed to explore the influencing factors for liver cirrhosis caused by HBV infection. Results The age of patients with HBV infection was mainly 31-50 years old (61.92%), who were mainly males (80.00%). The symptoms included yellow urine (66.30%), loss of appetitte (57.53%) and fatigue (46.85%). There was abnormal increase of aspartate aminotransferase and alanine aminotransferase, and hyperbilirubinemia in patients. 35 patients developed liver failure, of whcih 31 patients survived and were discharged, 3 patients underwent liver transplantation and 1 patient died after discharge. Among the 365 patients, there were 82 cases with HBV-related cirrhosis, mainly aged between 31 and 50 years old (63.41%), who were mainly males (80.00%). The main symptoms included abdominal distension (46.34%), liver palm (39.02%) and jaundice (34.15%), and all were accompanied with abnormal liver function indexes. Of the 365 patients, 35.37% of them were complicated with primary peritonitis, and 25.61% with electrolyte imbalance. In addition, 87.80% of the patients improved and were discharged. The incidence rates of upper gastrointestinal bleeding, hepatic encephalopathy and death were 7.32%, 3.66% and 1.22%, respectively. The results of univariate and multivariate analysis showed that drinking history, HBV-DNA level and exercise were the influencing factors of HBV-related cirrhosis (P<0.05). Conclusion Patients with HBV infection and related cirrhosis are mostly middle-aged men. Drinking history, HBV-DNA level and exercise are important influencing factors for HBV infection progression to cirrhosis.

Assessment of the presence of esophageal varices bleeding in patients with hepatitis B virus-related cirrhosis by a noninvasive score system / 中华传染病杂志

Objective To retrospectively analyze the diagnostic value of a noninvasive score system based on transient elastography (TE),serological test and imaging examination on esophageal variceal bleeding (EVB) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between April 2011 and December 2012,172 patients with HBV-related cirrhosis including 120 males and 52 females who visited clinic or hospitalized at the Department of Hepatology,Tianjin Third Central Hospital,were retrospectively enrolled.The mean age was (52.9 ± 10.6) years.Patients underwent upper gastrointestinal endoscopy to evaluate esophageal varices (EV) and were further categorized into three stages of mild,moderate and severe according to the morphology of EV and the risk of bleeding.Liver stiffness and spleen stiffness measurement were performed using Fibroscan.Portal vein width,splenic width and spleen thickness were measured using color Doppler ultrasound.All the patients were tested for white blood cell counts and platelet counts.With endoscopy as the gold standard,receiver operating characteristic (ROC) curves and the areas under curves (AUC) were used to assess the performance of the noninvasive score system in predicting EV by liver stiffness,spleen stiffness,portal vein width,spleen thickness and platelet counts.Student's t-test was performed to determine differences between continuous variables.Pearson's correlation was used to evaluate the association between EVB and these parameters.Results All these 172 patients underwent endoscopy.Among them,41 were EVB patients and 131 with no bleeding of EV.Among 172 EV patients,39 without EV,30 were mild EV,47 were moderate EV and 56 were severe EV.EVB was all positively correlated with liver and spleen stiffness,portal vein width,spleen thickness,splenic vein width (r=0.224,0.771,0.214,0.425 and 0.364,respectively; all P＜0.05).EVB was negatively correlated with platelet counts (r=-0.408,P=0.000).Liver stiffness,spleen stiffness,portal vein width,spleen thickness and splenic vein width in EVB patients were significantly higher than those in EV patients (P＜0.05).In contrast,platelet counts level was lower in EVB patients with difference of statistical significance (P＜0.05).AUC of non-invasive score system for EV and EVB were 0.953 and 0.882,respectively (P＜0.05).The optimal cut-off level of noninvasive score system for prediction of EV and EBV were 7 (sensitivity:96 ％,specificity:85 ％) in EV patients and 10 (sensitivity:78％,specificity:89 ％) in EVB patients.Conclusion Non-invasive score system based on liver stiffness,spleen stiffness,spleen thickness,width of splenic and portal vein and platelet counts is of clinical importance in assessing the presence of EV in patients with HBV-related cirrhosis,which is higher clinically valuable in the diagnosis for EV.

Nutritional Status in Alcohol- and Virus-Related Liver Cirrhosis / 대한간학회지

AIMS: The purpose of this study was to explore the differences of general characteristics and nutritional factors such as anthropometry and dietary intake between alcohol-related cirrhosis and virus-related liver cirrhosis and to assess the nutritional status of both of these groups. METHODS: In this study, the nutritional status of 67 patients with liver cirrhosis (25 with alcohol-related and 42 with virus-related) was evaluated by using clinical assessment, anthropometric measurements, dietary intakes, and biochemical indices. RESULTS: Although anthropometric measurements were not significantly different between alcoholic cirrhosis and viral cirrhosis, anthropometry of patients with viral cirrhosis had a higher tendency than that of alcoholic cirrhotic patients. Alcohol intake factors such as amount, duration, and frequency in alcoholic cirrhotic patients were higher than those in patients with viral cirrhosis. Energy excluding alcohol and vitamin C were significantly different between patients with alcoholic and viral cirrhosis. All subjects had lower intake of energy excluding alcohol, protein, vitamin A, thiamin, riboflavin, niacin, calcium, and iron as than recommended by the Recommended Dietary Allowances (RDA) for Koreans. Of special note was the fact that the intakes of energy excluding alcohol, vitamin A, riboflavin, and calcium were less than 75% of RDA for Koreans. Although the glucose and triglyceride levels were significantly different between alcoholic and viral cirrhotic patients, there were within normal range in both groups. There was an interaction effect in triceps skinfold thickness of the subjects according to both etiology and severity of liver disease. CONCLUSION: These data suggests that nutritional disorders are common in patients with both alcohol-and virus-related cirrhosis. It is necessary to educate patients with cirrhosis about the importance of a balanced dietary intake as well as its pattern, and quality of diet.

Observing on relationship in changes of OPN,IL-18 levels with hepatic function in patients with chronic hepatic disease infected by HBV / 中国免疫学杂志

Objective:To observe clinical significance between changes of OPN,IL-18 levels and relation ship with hepatic function in patients with chronic hepatic disease infected by HBV.Methods:The levels of OPN,IL-18 in peripheral blood of 102 patients with chronic hepatitis B,34 patients with hepatitis B-related cirrhosis,95 HBV carriers and 20 healthy people as the control group were respectively detected with ELISA.Results:The levels of OPN and IL-18 in chronic hepatitis B and hepatitis B-related cirrhosis groups were significantly increased compared with that of health control group(P