B型肝炎表面抗原帶原者肝硬化之多重危險因子研究

Multifactorial Study of Liver Cirrhosis among HBsAg Positive Carriers

王姿乃(Tsu-Nai Wang) ； 于明暉(Ming-Whei Yu) ； 廖運範(Yun-Fan Liaw) ； 林燈寅(Deng-Yn Lin) ； 陳建仁(Chien-Jen Chen)

《中華公共衛生雜誌》 13卷3期 (1994/06) Pp. 258-268

https://doi.org/10.6288/CJPH1994-13-03-06

摘要

台灣地區是B型肝炎病毒(HBV)的盛行地區，全人口當中有85%-90%曾經被感染，15%-20%成為HBV表面抗原(HBsAg)帶原者。雖然HBV被認為是台灣地區肝硬化最重要的危險因子，但是HBV並非肝硬化唯一的危險因子。本研究係以92名HBsAg陽性之肝硬化病例，與322名按性別、年齡配對選出之HBsAg陽性之健康帶原者對照為研究對象，以探討肝硬化的多重危險因子。研究結果顯示HBV e抗原(HBeAg)帶原狀況與肝硬化有密切相關，危險對比值達8.7倍。至於喝酒累積暴露量偏高、喝酒年數在20年以上、每月攝食3次以上醃製食品、有抽煙習慣、D型肝炎病毒抗體(anti-HDV)陽性者皆有偏高的危險性。進一步分析HBeAg與其他危險因子之交互作用，結果顯示HBeAg與抽煙、喝酒、anti-HDV、醃製食品攝食頻率，皆有協同作用存在。

關鍵字

肝硬化 ； B型肝炎表面抗原 ； B型肝炎e抗原 ； 流行病學 ； 多重危險因子

並列摘要

Independent and interactive effects related to the development of liver cirrhosis (LC) were assessed using a hospital-based case-control study for hepatitis B virus, hepatitis D virus, alcohol drinking, cigarette smoking and pickled food consumption. All of the 92 liver cirrhosis patients tested HBsAg positive were serially recruited from the HBV carriers clinic of the Chang-Gung Memorial hospital. The HBsAg positive but healthy controls who were matched one to three or four with liver cirrhosis cases on age, sex were selected from the same clinic. Liver cirrhosis risk factors were obtained from the study subjects through standardized interviews according to a structured questionnaire. The carrier status of HBsAg, HBeAg, anti-HBe and antibody of hepatitis D virus were determined by radioimmunoassay. A positive significant association with HBsAg positive liver cirrhosis was observed for the carrier status of HBeAg with an matched odds ratio of 8.7. Liver cirrhosis was with positive relationships to cumulative alcohol consumption, duration of alcohol drinking, pickled food consumption, cigarette smoking and anti-HDV. The data analyzed by conditional multiple logistic regression analysis showed significant interactive effects of HBeAg on habitual alcohol drinking, cigarette smoking, anti-HDV and pickled food consumption.

並列關鍵字

Liver cirrhosis ； HBsAg ； HBeAg ； Epidemiology ； Multifactorial