在西班牙裔患者中,积极饮酒与急性-慢性肝衰竭有关
Francisco Idalsoaga1, Luis Antonio Díaz1, Eduardo Fuentes-López2
1Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
概括
在非补偿性肝硬化患者中,急性至慢性肝衰竭 (ACLF) 与增加的酒精消费和显著更高的死亡率有关. 存在ACLF大大减少了生存时间,强调了它的严重性.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 急性至慢性肝衰竭 (ACLF) 代表了不补偿性肝硬化症的关键状况,其特点是高短期死亡率.
- 了解ACLF的患病率,酒精摄入等促成因素以及长期生存对于患者管理至关重要.
研究的目的:
- 根据ACLF的存在来表征缺乏补偿性肝硬化患者.
- 为了调查ACLF和积极饮酒之间的关联.
- 确定ACLF对拉丁美洲队列中长期生存的影响.
主要方法:
- 从2017年到2019年,在智利的三个大学中心进行了一项回顾性队列研究,涉及320名脱补偿性肝硬化患者.
- 使用EASL-CLIF标准来确定ACLF的诊断.
- 使用竞争性风险和时间到事件模型,包括加速失效时间 (AFT) 模型,进行了生存分析.
主要成果:
- 在320名患者中,有92名 (28.7%) 符合ACLF标准,功能衰竭是最常见的器官衰竭 (59.8%),感染是主要原因 (39.1%).
- 在ACLF患者中,MELD-Na得分更高,与酒精相关的肝病的频率更高 (36.7%与24.9%相比),以及更频繁的活性酒精摄入量 (37.2%与23.8%相比).
- ACLF独立地与较高的死亡率 (SHR 1.735) 和显著减少的死亡时间有关,特别是在ACLF-3 (TR 0.027) 中.
结论:
- 患有不补偿性肝硬化和ACLF的患者表现出高频率的积极饮酒.
- 在非补偿性肝硬化中存在ACLF是增加死亡率和减少生存时间的重要预测因素.
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