随着时间的推移发展肝硬化并发症的不平等:一个队列研究
George Cholankeril1,2, Thomas Taylor1,3, Jennifer R Kramer1,3
1Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
一半的肝硬化患者的病情进展,而许多患者的病情保持稳定. 较年轻的患者和与酒精有关的肝硬化表现出更快的进展,强调早期干预以获得更好的结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 临床流行病学临床流行病学
- 慢性肝病研究 慢性肝病研究
背景情况:
- 目前对肝硬化进展的理解依赖于过时的数据.
- 这项研究调查了大型退伍军人队列中的当代肝硬化进展模式.
研究的目的:
- 在现代患者群体中分析肝硬化进展动态.
- 确定影响从补偿性肝硬化过渡到各种并发症或死亡的因素.
主要方法:
- 追溯性队列研究包括24,679名患有补偿性肝硬化症的成年患者.
- 使用了半马尔科夫多态模型,具有7个状态和15个过渡.
- 纳入年龄和病因 (C型肝炎病毒,酒精,MASLD) 作为时间变化的因素.
主要成果:
- 近50%的患者进展为并发症,最常见的是炎 (30.3%).
- 12.9%的人直接因非肝脏原因死亡;26%的人继续获得补偿.
- 两年死亡风险 (13.5%) 超过任何并发症的风险.
结论:
- 肝硬化进展异质,其中很大一部分进展,保持稳定,或直接死亡.
- 年龄和病因 (例如,酒精,活跃的HCV) 是进展和结果的关键决定因素.
- 针对并发症前阶段的干预措施对于改善患者的治疗结果至关重要.
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