AP&T: 纤维化分期仍是原发性胆源性胆管炎预后的独立预测因子

2019-11-28 不详 MedSci原创

尽管肝纤维化在原发性胆源性胆管炎(PBC)患者的危险分层中的确切作用尚不确定,但纤维化分期可预测慢性肝病患者的预后。因此,本项研究旨在评估基线纤维化分期在生化风险分层背景下预测长期预后的效能。

背景
尽管肝纤维化在原发性胆源性胆管炎(PBC)患者的危险分层中的确切作用尚不确定,但纤维化分期可预测慢性肝病患者的预后。因此,本项研究旨在评估基线纤维化分期在生化风险分层背景下预测长期预后的效能。

方法
在一个具有全球代表性的大型PBC患者队列中,研究人员对1980年至2014年的患者进行的肝活检进行了评估。除1年治疗反应外以及组织学无创性纤维化指标(AST / ALT比[AAR],AST与血小板比指数[APRI]),组织学纤维化分期的预测能力以及治疗1年的反应能力,FIB-4),采用Cox比例风险模型评估了无移植生存期。

结果
本项研究共有1828例肝活检患者。除非侵入性纤维化措施外,晚期组织学纤维化(3/4期)是生存率的独立预测指标,危险比范围为1.59至2.73(P  <.001)。尽管进行了生化治疗反应,但具有晚期组织学纤维化阶段的患者的生存期较差,根据所使用的治疗反应标准,其10年生存率为76.0%-86.6%。

结论
纤维化分期的评估可提供超过1年生化治疗反应的预后价值。这凸显了将纤维化阶段纳入PBC患者的个体风险分层的必要性。

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    2019-11-29 txqjm

    谢谢了,学习

    0

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