胆固醇结石病可呈现有明显的转氨酶升高:系统性审查和元分析
Mouhand F H Mohamed1, Khaled Elfert2, Neha Wadhavkar3
1Division of Medicine, The Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02903, USA. mouhand@brown.edu.
Digestive diseases and sciences
|June 3, 2023
概括
常见的胆管结石会导致严重的肝损伤,超过三分之一的患者表现出肝酶升高 (ALT/AST>500 IU/L). 在胆固醇结石病例中也观察到极端升高 (ALT/AST > 1000 IU/L).
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 极端的转氨酶升高 (>1000 IU/L) 通常表明肝细胞损伤因缺血症,药物或病毒感染.
- 急性胆固醇结石 (常见的胆道结石) 可以模仿严重的肝细胞损伤,显著的转氨酶升高,与其通常的胆固醇呈现相反.
研究的目的:
- 为了确定患有常见胆道结石的患者严重转氨酶升高的患病率.
- 评估胆固醇胆病是否是明显的转氨酶升高的未被认可的原因.
主要方法:
- 在PubMed/Medline,EMBASE,Cochrane图书馆和谷歌学者中进行了系统的文献搜索.
- 对来自三项研究 (n=1328) 的数据进行了比例元分析,以汇集胆固醇胆固醇病中极端转氨酶升高 (ALT/AST > 1000 IU/L) 的频率.
- 随机效应模型被用于统计分析,以I2.2评估异质性.
主要成果:
- 在患有胆固醇性质病的患者中,氨酸氨基转移酶 (ALT) 或酸氨基转移酶 (AST) > 1000 IU/L 的综合频率为7.8% (95% CI:5.5-10.8%).
- ALT或AST> 500 IU/L的频率更高,其聚合频率为33.1% (95%CI:25.3-42%).
- 观察到异质性,I2值为>1000 IU/L的61%,>500 IU/L的88%.
结论:
- 这一元分析是第一个报告严重肝细胞损伤的患有普通胆道结石的患者的患病率.
- 大约三分之一的胆固醇胆固醇病患者的ALT/AST>500 IU/L,水平>1000 IU/L并不罕见.
- 在明显出现胆固醇胆病的病例中,可能不需要对严重的转氨酶升高的替代原因进行广泛的研究.
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