之前的腹腔外科手术是否会导致与乙氨基相关的急性肝衰竭?
Shannan R Tujios1, Isabel Wees1, Ahmad Anouti1
1Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas TX.
Clinical and translational gastroenterology
|May 13, 2025
概括
之前接受过减肥手术 (MBS) 的患者面临着亚美诺芬 (APAP) 诱导的肝损伤的更高风险. 在MBS患者中,无意的APAP过量服用导致严重的肝损伤,即使在较低剂量下,突出了对意识的关键需求.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 临床毒理学 临床毒理学
背景情况:
- 之前的研究表明,代谢性减肥手术 (MBS) 患者可能对乙氨基 (APAP) 诱导的急性肝衰竭/急性肝损伤 (ALF/ALI) 的敏感性增加.
- 本研究研究了ALF/ALI在患有或没有MBS史的患者中的表现,病因和结果的差异.
研究的目的:
- 为了比较急性肝损伤/衰竭 (ALF/ALI) 的特征和结果,先前接受过代谢性腹手术 (MBS) 的患者与没有接受过这种手术的患者进行了比较.
- 确定与MBS群体中ALF/ALI相关的特定风险和病因因素.
主要方法:
- 从急性肝衰竭研究小组 (ALFSG) 注册表 (1998-2019) 中分析了3,364名ALF/ALI受试者.
- 79名先前患有MBS的患者与没有MBS病史的患者进行比较,不包括6例病例.
- 对患者人口统计学,ALF/ALI病因学,过量服用模式和生存率的审查.
主要成果:
- 乙氨基 (APAP) 是MBS患者 (78.5%) 与非MBS患者 (49.3%) 相比,ALF/ALI的最常见原因.
- 在较低的中位数剂量 (6500毫克 vs 12000毫克) 中,MBS患者经历了更多的无意APAP过量.
- 尽管MBS患者的脑病变更严重,但21天和无移植生存率在各组之间相似.
结论:
- 急性肝衰竭/损伤 (ALF/ALI) 在先前接受过代谢性减肥手术 (MBS) 的患者中更为普遍.
- 乙氨基 (APAP) 毒性是主要的原因,通常是由于MBS群体的无意中低剂量过量.
- 提高MBS患者和医疗保健提供者的意识对于减轻APAP诱导的肝毒性风险至关重要.
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