慢性乙型肝炎患者转诊肝脏移植后核胺类同类停止
Grishma Hirode1, Mai Kilany1, Steven Pi2
1Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Journal of viral hepatitis
|May 15, 2025
概括
在慢性乙型肝炎 (CHB) 患者中,核胺类同类药物的停用可能导致肝脏快速衰退和肝移植 (LT) 转诊. 患者不应在没有医疗指导的情况下停止治疗,以避免严重的不良事件.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 临床医学 临床医学
背景情况:
- 核胺类比物 (NA) 有效抑制慢性乙型肝炎 (CHB) 病毒的发生.
- 在NA停止后了解不良肝脏事件对于患者的安全和管理至关重要.
- 肝移植 (LT) 可能是需要的CHB患者经历严重的失补偿后的NA退出.
研究的目的:
- 在停用NA导致LT转诊后,对CHB患者的肝脏不良事件进行表征.
- 在CHB患者中确定与NA停止相关的风险因素和结果.
主要方法:
- 11名CHB患者的回顾性病例系列在NA停药后被转介为LT.
- 排除患有肝细胞癌或共感染的患者.
- 对临床表现的分析,NA撤回的原因以及患者的结果.
主要成果:
- 大多数患者 (81.8%) 没有坚持NA治疗.
- 减补发生得很快,从NA停止到事件的中位数为3.2个月.
- 观察到大量的黄,,肝脏脑病和水出血.
- 45.5%的人接受了LT,36.4%的人在等待名单上,18.2%的人在评估期间死亡.
结论:
- 在NA停止后不久,CHB患者可能会经历严重的失补偿.
- 患者的不坚持是NA戒断的主要驱动因素.
- 医生必须仔细选择患者进行NA撤销,密切监测,并考虑及时重新治疗.
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