张普洪,刘树贤,刘殿武,柳慧.慢性肝病转归数学模型的建立和初步应用[J].Chinese journal of Epidemiology,2000,21(2):137-139 |
慢性肝病转归数学模型的建立和初步应用 |
Establishment and initial utilization of an arithmetic model of chronic hepatic diseases |
Received:April 10, 1999 |
DOI: |
KeyWord: 乙型肝炎 肝硬变 肿瘤 肝 数学模型 |
English Key Word: Hepatitis B Liver cirrhosis Liver neoplasm Arithmetic models |
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Abstract: |
目的 了解慢性乙型肝炎的自然史, 辅助公共卫生决策. 方法 建立慢性肝病转归的计算机模型. 模型框架包含慢性乙型肝炎 (CHB)、自愈 (NR)、代偿性肝硬化 (CIR)、失代偿性肝硬化(DEC)、原发性肝癌 (HCC)和死亡 (DEA)等阶段. 模型假设每年每一阶段患者都以不同的概率向其它可能的阶段转化, 参考有关文献确定了其间15个相互转化的概率公式, 并将它们融合到Foxpro语言编制的模型当中, 分别对假想的CHB和其他患者进行了长达55年的模拟. 结果 CHB发展为NR、CIR、DEC和HCC的中位年数依次为3、11、20和24年, CHB、CIR、DEC和HCC发展为DEA的中位年数分别为30、12、4和不足1年, 第30年时CHB患者的死因构成包括HCC(41. 3%)、DEC(33. 0% )和其它疾病 (25. 7%)三部分. 结论 模型模拟的主要结果经与过去的研究资料比较后证明是可靠的 |
English Abstract: |
Objective An arithmetic model was established to reflect the natural development of chronic hepatitis B, and to help decision making in public health. Methods The frame of this model was composed of 6 states-chronic hepatitis B (CHB), natural recovery (NR), compensated cirrhosis (CIR), decompensated cirrhosis (DEC), hepatocellular carcinoma (HCC) and death (DEA). It was supposed that each state would develop into the other possible states at different rates after different years. According to many related reports, 15 values or functions of transfer rates were calculated, and on the ground of them the present model-the Foxpro program was established. Hypothetical CHB and other patients had been introduced to simulate the natural course over 55 years. Results It was shown that the observation period when 50% of NR, CIR, DEC and HCC were developed from CHB were 3, 11, 20 and 24 years respectively. The CHB, CIR, DEC and HCC patients could last 30, 12, 4 and less than 1 year respectively before half of them died. At the 30 th year, proportions of death were 41. 3% from HCC, 33. 0% from DEC and 25. 7% from the other causes. Conclusion After the comparison between the main Results of the model and real reports from the past years, it could be concluded that the model was reliable. |
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