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在肝硬化患者的便calprotectin

Dinesh Jothimani¹, Ramya Paramasivam², Mullaiezhili Manoharan²

¹Institute of Liver Disease and Transplantation, Dr Rela Institute and Medical Centre, No 7, CLC Works Road, Chrompet, Chennai, 600 044, India. Dinesh.Jothimani@relainstitute.com.

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology

|October 12, 2023

概括

便中calprotectin (FCAL) 水平在肝硬化患者中升高,特别是那些急性至慢性肝衰竭 (ACLF) 患者. 一个FCAL水平≥200μg/g表明败血症,并预测这些患者的死亡率.

科学领域:

胃肠病学和肝病学胃肠学和肝病学
传染性疾病传染性疾病
临床生物化学临床生物化学

背景情况:

败血症是肝硬化的一个关键并发症,恶化肝功能,增加死亡率.
肠道失生症,肠道透性和免疫失调都与肝硬化性败血症有关.
便calprotectin (FCAL) 是一种炎症标志物,在炎症性肠病中得到了很好的研究.

研究的目的:

评估便calprotectin (FCAL) 在肝硬化患者的诊断和预后效用.
评估FCAL水平与败血症之间的相关性,以及该患者组的死亡率.

主要方法:

一项前性观察性研究,涉及肝硬化患者 (稳定,末期肝病 (ESLD) 和急性至慢性肝衰竭 (ACLF)) 和健康对照.
在住院后48小时内,收集便样本并对FCAL水平进行分析.
统计分析包括计算平均FCAL水平,接收器运行特征 (ROC) 曲线和败血症和死亡率的几率比率 (OR).

主要成果:

平均FCAL水平在ACLF患者中 (543.5μg/g) 与稳定的肝硬化患者 (143.3μg/g),ESLD患者 (176.9μg/g) 和健康对照 (109.2μg/g) 相比显著更高 (p=0.005).
在43.3%的患者中诊断出败血症,FCAL水平≥200μg/g与败血症密切相关 (OR=10.8,p=0.006),ROC曲线下的面积为0.80.
死亡率为25.7%,非幸存者中的FCAL水平明显高 (493.67μg/g) 与幸存者 (199.71μg/g) 相比 (p=0.005).

结论:

在慢性肝病中,FCAL水平升高,在ACLF中观察到的度最高.
超过200μg/g的FCAL值是肝硬化患者败血症和死亡率的重要指标.
需要进一步的研究,但使用FCAL早期检测败血症可能有助于指导抗菌疗法并改善结果.

关键词:

急性-慢性肝功能衰竭肝功能衰竭肝功能衰竭最终阶段的肝脏疾病.便中的calprotectin是什么肝硬化是肝硬化的一种疾病.败血症这是一种败血症.

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