热带病与寄生虫学

热带病与寄生虫学 ›› 2021, Vol. 19 ›› Issue (4): 189-.

• 论著 • 上一篇    下一篇

肝泡型棘球蚴病并发肺泡型棘球蚴病相关危险因素分析

陈锐1,2,王志鑫1,2,许晓磊1,2,王凯强1,2,周留馨1,2,樊海宁1,2,王海久1,2
  

  1. 1. 青海大学附属医院肝胆胰外科,青海 西宁 810001; 2. 青海省包虫病研究重点实验室
  • 出版日期:2021-08-20 发布日期:2021-08-26
  • 通信作者: 王海久,E-mail:yjsgp@ sina. cn
  • 作者简介:陈锐,男,硕士,医师,研究方向:肝胆胰疾病及棘球蚴病诊治。 E-mail:cr_4737@ 163. com
  • 基金资助:
    青海省科技厅重大科技专项(2016-SF-A5);青海省包虫病研究重点实验室( 2020-ZJ-Y01);中科院“西部之光”青年学者项目;青海
    “高端创新人才千人计划”培养拔尖人才项目

Analysis on the related risk factors for hepatic alveolar echinococcosis complicated with lung alveolar echinococcosis 

CHEN Rui1,2,WANG Zhi-xin1,2,XU Xiao-Lei1,2,WANG Kai-qiang1,2,ZHOU Liu-xin1,2,FAN Hai-ning1,2,WANG Hai-jiu1,2   

  1. 1. Department of Hepatopancreatobiliary Surgery,Affiliated Hospital of Qinghai University,Xining 810001,Qinghai Province,China;2. Qinghai Province Rearch Key Laboratory for Echinococcosis
  • Online:2021-08-20 Published:2021-08-26

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摘要： 目的 探讨肝泡型棘球蚴病并发肺泡型棘球蚴病的相关危险因素。 方法 收集青海大学附属医院肝胆胰外科 2017 年 10 月至 2019 年 4 月收治的肝泡型棘球蚴病并发肺泡型棘球蚴病的患者(并发组)以及肝泡型棘球蚴病未并发肺泡型棘球蚴病患者(对照组)的一般资料、实验室和影像学检查资料,分析并发肺泡型棘球蚴病发生的影响因素。 结果 共收集肝泡型棘球蚴病并发肺泡型棘球蚴病患者 49 例,肝泡型棘球蚴病未并发肺泡型棘球蚴病患者 55 例,两组间性别及年龄构成差异均无统计学意义( χ2 = 2. 164、2. 780, P均>0. 05)。 单因素分析结果提示,HBeAg 以及肝内病灶侵犯肝后下腔静脉、肝动脉、肝静脉和门静脉情况是肝泡型棘球蚴病并发肺泡型棘球蚴病的影响因素。 二元多因素 Logistic 回归分析结果提示,肝内病灶侵犯肝后下腔静脉和肝内病灶侵犯肝静脉是肝泡型棘球蚴病并发肺泡型棘球蚴病的独立危险因素。 结论 对于肺部病灶界定不明确的肝泡型棘球蚴病患者,可以根据术前肝内病灶影像学特征并结合肺部病灶影像学结果作出判断,进而采取有针对性的干预措施,实现患者临床受益最大化。

关键词: 肝泡型棘球蚴病, 肺泡型棘球蚴病, 影像学诊断, 血管侵犯, 危险因素

Abstract: Objective To investigate the related risk factors for hepatic alveolar echinococcosis complicated with lung alveolar echinococcosis. Methods General data,laboratory and imaging findings were collected from the patients of hepatic alveolar echinococcosis complicated with lung alveolar echinococcosis (combined group) and those of hepatic alveolar echinococcosis without lung alveolar echinococcosis (control group),treated in the Department of Hepatopancreatobiliary Surgery of Affiliated Hospital of Qinghai University between October 2017 and April 2019. Then the related factors affecting occurrence of hepatic alveolar echinococcosis concomitant with lung alveolar echinococcosis were analyzed. Results Forty-nine cases of hepatic alveolar echinococcosis complicated with lung alveolar echinococcosis,and 55 cases of hepatic alveolar echinococcosis without lung alveolar echinococcosis were included. There was no significant difference in gender and age between groups( χ2 = 2. 164,2. 780,respectively,both P>0. 05). Univariate regression analysis indicated that HBeAg,infiltration of the intrahepatic lesions into posterior-inferior vena cava,hepatic arteries,hepatic veins and portal veins were the influencing factors for hepatic alveolar echinococcosis concomitant with lung alveolar echinococcosis. Multivariate logistic regression analysis showed that invasion of intrahepatic lesions into posterior-inferior vena cava and hepatic veins were independent risk factors for hepatic alveolar echinococcosis complicated with lung alveolar echinococcosis. Conclusion For patients of alveolar echinococcosis with ambiguous lung lesions,sound judgment can be made in accordance with preoperative imaging findings of intrahepatic lesions and lung lesions,with implementation of targeted intervention,so as to maximize the clinical benefits for such patients.

Key words: Hepatic alveolar echinococcosis, Lung alveolar echinococcosis, Imaging diagnosis, Vascular invasion, Risk factors

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