【摘要】 目的　为了摸清并掌握陕北原发性肝癌 (HCC)的主要危险因素 ,探索病因模式 ,为采取有效预防措施提供科学依据 .方法　以 1999- 12 /2 0 0 0 - 12在陕北 3所市级医院确诊的88例 HCC住院患者为研究对象 ,进行了 1:2配比病例对照研究 .结果　单因素条件 logistic回归分析结果 :P<0 .0 1的因素有个人肝病史、HBs Ag,anti- HBc,HBe Ag,anti- HBe,内向性格、平时心情、乙肝家族史 ,其 OR分别为 19.5 ,5 4 .9,12 .1,4 .4 ,2 7.3,2 .1,10 .1和 11.3.P<0 .0 5的因素有 anti-HBs、吸烟、饮酒、负性生活事件、HCC家族史 ,其 OR分别为0 .4 ,1.8,2 .0 ,2 .0和 2 .7.多因素条件 logistic回归分析 ,以P<0 .0 5为保留条件进入最终模型的因素有 :HBV感染、个人肝病史、平时的心情、饮酒和乙肝家族史 .未发现因素之间有相乘模型的交互作用 .结论　陕北 HCC的主要危险因素是HBV感染、个人肝病史、平时心情、饮酒和乙肝家族史 .另外负性生活事件、内向性格、HCC家族史和吸烟也与 HCC的发生有关 .anti- HBs是唯一的保护因子 .预防和控制陕北原发性肝癌最根本、最有效的措施是接种乙肝疫苗 .更多还原

【Abstract】 AIM To explore major risk factors and etiological patterns of hepatocellular carcinoma (HCC) in North Shaanxi so as to provide a scientific basis for effective prevention of HCC. METHODS A 1∶2 matched case control study was conducted in North Shaanxi including inpatients of 3 hospitals, from December 1999 to December 2000, when the cases and controls survived. RESULTS Uni variable conditional logistic regression analysis showed that ( P <0.01) significant factors were individual history of liver diseases, HBsAg, anti HBc, HBeAg, anti HBe, introversive character,usual mood, family history of HBV infection, with ORs 19.5, 54.9, 12.1, 4.4, 27.3, 2.1, 10.1 and 11.3 respectively. The P <0.05 significant factors were anti HBs, smoking, drinking, negative life events and family history of hepatocellular carcinoma with ORs 0.4, 1.8, 2.0, 2.0 and 2.7 respectively. Analyzed by multiple conditional logistic regression ( P <0.01 as retaining condition in fitting model), factors that finally entered the model were HBV infection, individual history of liver diseases, usual mood, drinking and family history of HBV infection. There was no interaction of multiplicative model among factors by interaction analysis. CONCLUSION The above results suggested that major risk factors were HBV infection, individual history of liver diseases, usual mood, drinking and family history of HBV infection. Besides, negative life events, introversive character, family history of PHC and smoking factors were also related to hepatocellular carcinoma. Anti HBs was the only protective factor. Thus, immunization with HBV vaccine of the entire population is the essential and effective measure to prevent and control hepatocellular carcinoma in North Shaanxi.更多还原