在患有精神疾病的患者中评估肝纤维化
Paul Carrier1, Morgane Chalange2, Murielle Girard3
1Fédération d'Hépatologie. CHU Limoges. 2, avenue Martin Luther King, 87042 Limoges, France; Pôle universitaire de psychiatrie d'adulte, personne âgée et addictologie (PUP3A), Centre Hospitalier Esquirol. Rue du Dr Marcland, 87025 Limoges, France; INSERM UMR-1248. Faculté de Médecine et de Pharmacie. 2, rue Dr Marcland, 87025 Limoges, France.
Clinics and research in hepatology and gastroenterology
|June 20, 2025
概括
患有严重精神疾病的患者患有6%的晚期肝纤维化和34.9%的严重肝硬化. 高血压是纤维化的一个关键风险因素,而高的BMI和甘油三与肥胖症有关.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 精神疾病和精神疾病正在增加公众健康问题.
- 伴随性体质疾病,特别是肝脏疾病,危及精神病患者的预期寿命.
- 在这种人群中查肝纤维化具有独特的挑战.
研究的目的:
- 在患有严重精神疾病的患者中评估肝纤维化和脂肪的患病率.
- 在这个队列中,确定与肝纤维化和肝硬化相关的危险因素.
- 强调需要在精神病患者中进行系统性肝病查.
主要方法:
- 一大批患有严重精神障碍的患者,服用精神药物2年以上,被前性地纳入.
- 使用FibroScan®测量肝硬度 (LS),评估肝纤维化.
- 控制减弱参数TM (CAP) 评估了肝脏肥胖症.
主要成果:
- 在355名患者中,发达纤维化 (LS>8kPa) 在6%的患者中被发现;高血压是唯一重要的独立预测因子 (p=0.002).
- 显著的肥胖症 (CAP>275 dB/m) 影响了34.9%的患者,独立地与高体重指数 (BMI) 和高甘油三酸相关.
- 单变量分析揭示了纤维化和高费里之间的关联,以及肥胖症和睡眠呼吸暂停,酒精依赖,2型糖尿病,代谢综合征和代谢功能障碍相关的肝病之间的关联.
结论:
- 精神病患者表现出患肝纤维化和胆固醇症的重大风险.
- 在这个脆弱人群中,建议对肝脏疾病进行系统查.
- 需要进行进一步的研究,以确定精神病患者肝脏疾病的最佳预防和治疗策略.
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