患有原发性胆道胆炎和严重肝硬度的低风险个体:预后和治疗
Dawei Ding1, Yinan Hu1, Gui Jia1
1State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, The Air Force Military Medical University, Xi'an, 710032, Shaanxi, China.
Hepatology international
|December 11, 2024
概括
患有低风险GLOBE评分和高肝硬度 (LSM>11kPa) 的患者预后不佳. 在这个群体中,抗纤维素治疗可能会减缓肝硬度的进展.
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:
- 一些接受乌尔索多西胆酸 (UDCA) 或纤维酸盐治疗的患者表现出受控的生物化学反应,但肝硬度高.
- 这些患者的预后和治疗需要进一步调查.
研究的目的:
- 探索低风险和高肝硬度患者的预后和治疗策略.
- 为了评估肝硬度测量 (LSM) 和GLOBE评分的综合预后值.
主要方法:
- 对424例UDCA单一治疗病例和102例联合费诺纤维酸治疗病例的回顾性研究.
- 分析肝硬度测量 (LSM) 和GLOBE评分用于预后预测.
主要成果:
- 结合的LSM和GLOBE得分改善了UDCA治疗患者的预后预测 (AUC0.868).
- 在低风险患者 (GLOBE < 0.5) 中,LSM 显示了附加的预后效应,特别是 LSM > 11 kPa.
- 抗纤维素治疗没有减少主要结局,但在低风险,高LSM患者中减缓了LSM进展.
结论:
- 根据GLOBE定义的低风险和LSM> 11kPa的患者的预后不好.
- 抗纤维素治疗可能有助于减缓肝硬性的进展,对于这个特定的患者群体.
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