Objective: To understand and compare the differences between age, sex and liver diseases-related mortality risk in patients with hepatitis B virus-related liver cirrhosis. Methods: Based on the front-page inpatient medical record database and the death registration system of Beijing patients with hepatitis B-related liver cirrhosis from 2008 to 2015 were included. The survival information of all patients were traced up to the occurrence of liver disease-related mortality event or until December 31, 2019. Kaplan-Meier method was used to calculate the cumulative incidence of liver disease-related mortality in patients with liver cirrhosis. Cox regression model was used to analyze the effect of age-gender interaction on liver disease-related mortality risk. Results: A total of 16 738 patients with hepatitis B-related liver cirrhosis were included, of which 13 969 cases (83.46%) were in compensated stage and 2 769 cases (16.54%) were in decompensated stage. Liver cirrhosis complications mortality risk in patients with compensated stage cirrhosis at 3, 5, and 8 years were 10.84%, 12.70%, and 14.37%, respectively; while in decompensated stage patients, the mortality risk was 16.70%, 19.02%, and 20.73%, respectively. The 3, 5, and 8-year liver cancer mortality rates of patients with compensated stage liver cirrhosis were 5.24%, 7.49%, and 10.25%, respectively; while those with decompensated stage liver cancer mortality rates were 9.01%, 11.16%, and 13.50%, respectively. Liver disease-related mortality risk was increased with age in patients with liver cirrhosis. Liver cirrhosis complications mortality risk in female patients with liver cirrhosis at age < 60 years was lower than that of male patients. Liver cirrhosis complications mortality risk in male and female patients aged 60-69 years were similar. Liver cirrhosis complications mortality risk in female patients aged ≥70 years was higher than that of male patients. However, female patients had a lower risk of liver cancer mortality than male patients in utmost age groups. Conclusion: Age is positively correlated with liver diseases-related mortality risk in patients with hepatitis B-related liver cirrhosis. Female sex is a protective factor for liver cancer mortality in patients with liver cirrhosis, and the protective effect on liver cirrhosis complications mortality risk gradually disappears with age.
目的： 了解乙型肝炎肝硬化患者的肝脏相关死亡风险及比较不同年龄别和性别肝病相关死亡风险的差异。 方法： 基于北京市住院病案首页数据库和北京市死因登记系统，纳入2008年至2015年北京市乙型肝炎肝硬化住院患者，所有患者的生存信息均追踪至发生肝脏相关死亡事件或到2019年12月31日为止。采用Kaplan-Meier法计算肝硬化患者肝脏相关死亡事件累积发生率，采用Cox回归模型分析年龄-性别交互作用对肝脏相关死亡事件发生风险的影响。 结果： 共纳入16 738例乙型肝炎肝硬化患者，其中代偿期13 969例（83.46%），失代偿期2 769例（16.54%）。代偿期肝硬化患者3、5、8年肝硬化并发症病死率为10.84%、12.70%、14.37%；失代偿期患者分别为16.70%、19.02%和20.73%。代偿期肝硬化患者3、5、8年肝癌病死率分别为5.24%、7.49%和10.25%；失代偿期患者分别为9.01%、11.16%和13.50%。肝硬化患者肝脏相关死亡风险随年龄增长而增高。年龄< 60岁时女性肝硬化患者肝硬化并发症死亡风险低于男性，年龄60～69岁时男女性患者肝硬化并发症死亡风险接近，年龄≥70岁时女性患者肝硬化并发症死亡风险超过男性；而女性患者在多数年龄段肝癌死亡风险均低于男性。 结论： 年龄与肝硬化患者肝脏相关死亡风险呈正相关；女性是肝硬化患者肝癌死亡的保护因素，而对肝硬化并发症死亡风险的保护作用随着年龄增长而逐渐消失。.
Keywords: Chronic hepatitis B; Death; Hepatocellular carcinoma; Host factor; Liver cirrhosis; Liver cirrhosis complication.