与乙型肝炎病毒相关的急性至慢性肝衰竭患者的补偿特征和预后
Junchao Zhang1, Yehong Lin2, Yueyong Zhu3
1Department of Gastroenterology, Xiamen Hospital of Traditional Chinese Medicine.
European journal of gastroenterology & hepatology
|November 26, 2024
概括
获得补偿的乙型肝炎病毒相关的急性至慢性肝衰竭 (ACLF) 患者表现出更好的预后和生存率. 即使在补偿后,对肝细胞癌 (HCC) 的定期监测也至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 胃肠病学 胃肠病学
背景情况:
- 与乙型肝炎病毒 (HBV) 相关的急性至慢性肝衰竭 (ACLF) 是一个重大的临床挑战.
- 了解影响ACLF补偿和长期结果的因素对于患者管理至关重要.
研究的目的:
- 研究HBV相关的ACLF中补偿的特征.
- 确定与ACLF患者补偿相关的预后和生存率.
主要方法:
- 一组136名患有与HBV相关的ACLF的患者进行了随访.
- 根据1年的结果,患者被分为补偿和非补偿组.
- 使用Kaplan-Meier方法分析生存率和补偿率.
主要成果:
- 41.18%的ACLF患者在1年内实现了补偿.
- 补偿组表现出较少的严重肝损伤,更高的α-fetoprotein和较低的MELD分数.
- 在3,6,12,36和60个月的生存率分别为44.9%,43.4%,43.4%,40.4%和40.4%.
- 在90天以上的幸存者中,93.44%的幸存者表现出补偿,累计补偿率在24个月内达到97.3%.
- 87.7%的补偿患者保持稳定,而10.5%的患者患有肝细胞癌 (HCC).
结论:
- 较轻度的肝硬化,减少炎症和增强的肝再生促进了ACLF的补偿和更好的长期预后.
- 即使在补偿后,肝细胞癌 (HCC) 的发展也是一个潜在的风险,需要定期监测.
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