临床显著的门性高血压在患有初级胆道胆管炎的患者:临床病理特征和预后价值
Ying Zhang1, Huaying Lai1, Jing Chen1
1Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, PR China; Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, Fujian Province, PR China.
Annals of hepatology
|September 14, 2024
概括
在初级胆管胆炎 (PBC) 患者中,临床显著的门脉高血压 (CSPH),特别是在早期阶段,预测结果不佳. 组织学特征,如围状纤维化和结节性再生性增生,是关键指标.
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:
- 初级胆道胆炎 (PBC) 在肝硬化发病之前可以导致临床显著的门脉高血压 (CSPH).
- 早期发现CSPH及其相关风险因素对于管理PBC患者至关重要.
研究的目的:
- 为了确定PBC患者中CSPH的发病率.
- 分析临床病理学特征及其在PBC中的预后价值,特别是在早期组织学阶段.
- 评估CSPH对早期PBC的长期结果的预测价值.
主要方法:
- 在2013年1月至2022年4月期间诊断的PBC患者的回顾性招生.
- 评估基线临床病理学特征的预后价值.
- 卡普兰-梅尔生存分析和COX回归分析用于CSPH的PBC患者的长期结果.
主要成果:
- 在47.2%的PBC患者中,发现了CSPH,在早期组织学阶段有20.6%.
- CSPH显著预测了较低的无肝移植生存率 (HR,6.78).
- 围状纤维化和结节再生性增生 (NRH) 在早期CSPH中很常见. 纤维性七分体 (HR,4.85) 和胆固醇 (HR,7.70) 独立预测了不良结果.
结论:
- CSPH是PBC患者不良结果的重要风险因素,特别是早期组织学阶段的患者.
- 围状纤维化和NRH是早期PBC中CSPH的有价值的组织学指标.
- 早期评估CSPH及其特征有助于制定针对PBC的个性化治疗策略.
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