Objective: The incidence of liver fibrosis in patients with chronic hepatitis C is high. Without effective treatment, it would lead to liver cirrhosis. This study is to identify the related factors for the incidence of liver fibrosis in patients with chronic hepatitis C in order to make early intervention treatment and reduce the case fatality rate. Methods: This cross-sectional survey was conducted in adults aged ≥50 years with local residence for more than 5 years in Jurong of Jiangsu province from March to May in 2015, the patients infected with hepatitis C virus through remunerated blood donation were screened and included in the analysis. Descriptive statistical analysis was done to compare the differences in the incidence of liver fibrosis among the patients with different age, sex and education level or co-infected with hepatitis B virus or not. The risk factors for severe liver fibrosis were identified with univariate and multivariate logistic regression analysis. Liver fibrosis was diagnosed by using FIB-4 index method. Results: A total of 719 patients with chronic hepatitis C were surveyed. Severe liver fibrosis developed in 285 of the 719 patients, in whom 21.84% was males. Multivariate logistic regression analysis showed that the patients with higher education level (OR=0.65, 95%CI: 0.47-0.90) and with access of antiviral therapy (OR=0.33, 95%CI: 0.22-0.49) had lower risk for severe liver fibrosis, the patients with high fasting blood glucose level (OR=1.80, 95% CI: 1.19-2.77) and abnormal white blood cell count (OR=2.77, 95% CI: 1.95-3.90) had higher risk for severe liver fibrosis. Conclusions: The incidence of severe liver fibrosis in patients with hepatitis C was affected by many factors. Higher education level and antiviral therapy were the protective factors, but high fasting blood glucose level and abnormal white blood cell count were the risk factors.
目的： 探索既往有偿献血人群慢性丙型肝炎患者严重肝纤维化发生的影响因素，以便对可能发展成为严重肝纤维化的病例进行早期干预治疗，降低病死率。 方法： 2015年3-5月对江苏省句容市年龄≥50周岁且居住≥5年者进行横断面调查，筛查出既往有偿献血途径感染慢性丙型肝炎的患者作为研究对象。应用EpiData 3.10软件和Stata 12.0软件对数据进行录入及统计学分析。采用描述性统计分析方法比较性别、文化程度、实验室生化指标、是否合并乙型肝炎感染等组间发生严重肝纤维化的差异，采用单因素和多因素logistic回归分析相关因素与严重肝纤维化发生的关系。肝纤维化诊断采用FIB-4指数法。 结果： 共纳入慢性丙型肝炎患者719例，其中肝纤维化285人；男性占21.84%，女性占78.16%。多因素logistic回归分析结果显示，文化程度高（OR＝0.65, 95%CI：0.47～0.90）和接受抗病毒治疗（OR＝0.33，95%CI：0.22~ 0.49）者发生严重肝纤维化风险较低，FPG高（OR＝1.80，95%CI：1.19~ 2.77）和白细胞计数异常（OR＝2.77，95%CI：1.95~ 3.90）者发生严重肝纤维化的风险较高。 结论： 丙型肝炎患者严重肝纤维化的发生受到诸多因素的影响。其中文化程度高和抗病毒治疗是慢性丙型肝炎患者发生严重肝纤维化的保护因素，FPG高和白细胞计数异常是慢性丙型肝炎患者发生严重肝纤维化的危险因素。.
Keywords: Hepatitis C; Liver fibrosis; Remunerated blood donation population.