胰腺参与及其在急性-慢性肝衰竭的预后影响
Georg Kramer1, Vlad Taru2, Benedikt Simbrunner1
1Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria; Clinical Research Group MOTION, Medical University of Vienna, Vienna, Austria; Christian-Doppler Laboratory for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, Vienna, Austria.
胰腺酶的升高,特别是脂酶,在急性至慢性肝衰竭 (ACLF) 中很常见. 诊断后第7天的脂酶水平独立预测了ACLF患者的死亡率.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 关键护理医学 关键护理医学
背景情况:
- 急性慢性肝衰竭 (ACLF) 是肝硬化患者的一种严重疾病,其特点是多器官衰竭和高死亡率.
- 胰腺在ACLF病原和预后中的作用仍然不太清楚.
研究的目的:
- 评估 ACLF.患者中升高的脂酶 (eLIP) 和氨酶 (eAMY) 的患病率,进展和预后影响.
- 为了确定胰腺酶的升高是否有助于预测ACLF的结果.
主要方法:
- 从2003年至2022年对193名ACLF患者 (EASL-CLIF标准) 的回顾性分析.
- 定义的升高的脂酶和粉酶是正常的上限≥3倍.
- 诊断时收集的酶数据 (D0) 和诊断后的7,28,90天;使用后勤和考克斯回归模型分析了与eLIP和生存相关的因素.
主要成果:
- 在D0的患者中,脂酶和粉酶的升高分别在43.5%和50.2%的患者中存在,具有强烈的相关性.
- 升高的脂酶在D0时观察到8.8%,在D7.时观察到15.7%.
- 虽然D0酶水平没有预测死亡率,但D7的升高脂酶独立预测了28天 (aHR: 2.15) 和90天 (aHR: 2.14) 的死亡率.
结论:
- 增加的脂酶和氨酶水平是ACLF患者经常发现的发现.
- 在ACLF第7天升高的脂酶水平是死亡率的重要独立预测指标.
- 这些发现表明胰腺参与在ACLF进展和结果中的作用.
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