肝硬化和肉症患者的TIPS后的结果:系统性审查和元分析
Maria de Brito Nunes1,2,3, Maria Gabriela Delgado1, Jaume Bosch1
1Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
JHEP reports : innovation in hepatology
|February 2, 2026
概括
跨内肝移植系统分流 (TIPS) 放置改善了超过一半的肝硬化患者的肉症. 虽然肉类症增加了明显的肝脑病变风险,但其对TIPS后死亡率的影响尚不清楚.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 临床营养学 临床营养学
背景情况:
- 肉症是肝硬化中常见的疾病 (40-70%),影响患者的治疗结果.
- 跨内肝移植系统分流 (TIPS) 是门高血压并发症的关键干预措施.
研究的目的:
- 为了评估TIPS后的肉症改善情况.
- 为了确定sarcopenia和明显的肝脑病变 (HE) 之间的关联,在TIPS之后.
- 评估萨科佩尼亚和TIPS后死亡率之间的关系.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 包括20项通过基于CT的骨肌肉指数 (L3-SMI) 或psoas肌肉指数 (L3-PMI) 评估萨尔科佩尼亚的研究.
- 搜索了八个数据库,寻找各种研究设计,包括RCT,队列和病例控制研究.
主要成果:
- 在TIPS患者中,肉类的综合流行率为55.4%.
- 在TIPS后的患者中,57%的肉病改善,平均L3-SMI增加4.53cm2/m2.
- 萨科佩尼亚与明显的HE (OR=3.40) 的更高几率有显著的相关性,但与死亡率没有相关性 (HR=1.95,p=0.078).
结论:
- 在肝硬化患者中,TIPS可能会导致萨尔科佩尼亚的改善.
- 肉类是TIPS后明显肝脏脑病变的危险因素.
- 麻症和TIPS后死亡率之间的关联需要进一步调查.
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