老年患者慢性肝病 - 患者评估和管理
Daniel Anthony DiLeo1, Tolga Gidener2, Ayse Aytaman3
1Department of Gastroenterology, Brooklyn Campus of the Veterans Affairs New York Harbor Healthcare System, 800 Poly Pl, Brooklyn, NY, 11209, USA. Daniel.DiLeo@va.gov.
Current gastroenterology reports
|November 22, 2023
概括
晚期慢性肝病 (ACLD) 的老年患者需要量身定制的管理. 早期识别和干预风险因素,并发症和脆弱性对于改善这个不断增长的人口的结果至关重要.
科学领域:
- 老年医学 老年医学
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
背景情况:
- 全球人口老龄化导致老年患者患有晚期慢性肝病 (ACLD) 的患病率增加.
- 由于伴随着衰老的并发症和生理变化,在老年人中管理ACLD存在独特的挑战.
研究的目的:
- 审查ACLD老年患者肝损伤的危险因素.
- 探索评估肝病进展的非侵入性方法.
- 讨论ACLD老年人的肝硬化并发症,虚弱和肉症的管理.
主要方法:
- 审查更新的指导方针和与老年人ACLD相关的最新发现.
- 在老年人群中验证新的纤维化得分截止值 (例如,FIB-4,代谢功能障碍相关的脂肪性肝病 (MASLD)).
- 评估治疗策略,包括改变生活方式,药物治疗和特定并发症的管理.
主要成果:
- 更新的指导方针和验证的纤维化得分 (FIB-4, MASLD) 对老年ACLD患者至关重要.
- MASLD患者从热量限制,运动和GLP-1激动剂中受益;ACLD患者需要对酒精使用障碍进行查.
- 卡维迪醇和利尿剂可以安全地用于门高血压和炎,并进行监测;营养不良,虚弱和肉症需要早期干预.
结论:
- 在老年人中早期发现ACLD可以积极管理风险因素和并发症.
- 生活方式和药理干预可以减少老年ACLD患者的减补和死亡率.
- 对这一群体的非侵入性成像,营养支持和抗生素预防策略需要进一步的研究.
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