2015-2023年蒙古17711人中晚期慢性肝病的发展趋势
Habiba Kamal1,2, Ganbolor Jargalsaikhan3,4, Sanjaasuren Enkhtaivan3,4
1Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden.
Journal of viral hepatitis
|January 6, 2026
概括
蒙古的晚期慢性肝病 (aCLD) 患病率下降,主要是由于降低了C型肝炎病毒 (HCV) 感染. 然而,慢性肝炎D病毒 (HDV) 病例增加,凸显了需要更好地获得护理和治疗,特别是对于高危人群.
科学领域:
- 肝病学和胃肠病学 肝病学和胃肠学
- 传染病 流行病学 流行病学
- 公共卫生研究 公共卫生研究
背景情况:
- 慢性肝病在亚洲对健康造成重大负担,蒙古的肝癌发病率在全球最高.
- 了解晚期慢性肝病 (aCLD) 的模式和风险因素对于有针对性的干预至关重要.
研究的目的:
- 在蒙古队列中描述晚期慢性肝病 (aCLD) 的患病率,趋势和相关因素.
- 评估病毒性肝炎感染对aCLD随时间变化趋势的影响.
主要方法:
- 对17711名成年人 (≥18岁) 进行HBsAg测试的横截面分析,可用肝硬度测量 (LSM) 和/或血小板计数.
- aCLD定义为LSM≥12.5kPa或血小板数<150*10^9细胞/L.
- 用于评估与aCLD相关的因素和发病率的年百分比变化 (APC) 的物流回归模型.
主要成果:
- 14.2%的参与者患有CLD,平均年龄为50.1岁; 61.6%的HBsAg阳性,78.6%的抗HDV阳性,64.6%的HDVRNA阳性.
- 总体而言,aCLD率下降 (APC -7.8%),主要是由于抗HCV阳性病例的减少 (APC -15.0%).
- 相反,抗HDV阳性病例显著增加 (APC为3.3%),大多数aCLD患者面临中等至高5年HCC风险.
结论:
- 虽然与HCV相关的aCLD在蒙古正在下降,但HDV驱动的肝病的患病率不断上升需要紧急关注.
- 很大一部分aCLD患者患有肝细胞癌 (HCC) 的风险很高,这凸显了治疗缺口.
- 改善与护理的联系和加强对抗病毒疗法的获取是至关重要的,特别是对于中年人来说,肝病进展的风险更高.
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