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Hepatology:儿童癌症幸存者血清ALT升高:圣裘德终生队列研究报告

2018-07-30 MedSci MedSci原创

3级或4级肝损伤在CCS中并不常见。在这一组,生活方式的改变可能影响轻度肝损伤的状况。

研究的背景和原理:确定成年儿童癌症幸存者(CCS)的血清丙氨酸氨基转移酶(ALT)水平升高的流行率和风险因素。

研究方法和患者:本研究从St. Jude终生队列研究(>10年后诊断,患者年龄≥18岁)中收集到2751例CCS患者。使用不良事件的通用术语标准对血清谷丙转氨酶(ALT)水平进行分级;采用改进的泊松回归模型对所选模型的相对风险(RR)和95%置信区间(CI)进行估计,以确定人口因素与临床因素以及1 - 4级ALT之间的相关性。

研究主要内容:1339例患者(48.7%)是女性;2271(82.6%)的患者是非西班牙裔白人。评估患者中位年龄为31.4岁(四分位数范围(IQR) = 25.8 - 37.8岁);从诊断到评估的时间中位为23.2年(IQR = 17.6 - 29.7)。1137(41.3%)例患者的血清ALT评分高于正常值[不良事件通用术语标准v4.03 一级-1058 (38.5%); 二级-56 (2.0%); 3级-23  (0.8%); 等级4 -无)。多变量模型证明了非西班牙裔白人种族、评估时的年龄, 超重或肥胖,代谢综合征, 阿托伐他汀、普伐或辛伐他汀的使用,丙型肝炎病毒感染,治疗前使用白消安或硫鸟嘌呤, 肝脏手术的病史以及使用≥10 Gray, ≥15 Gray或≥20 Gray处理肝脏的比例都与ALT升高相关。

研究结论:3级或4级肝损伤在CCS中并不常见。在这一组,生活方式的改变可能影响轻度肝损伤的状况。

原始出处:

Green DM, Wang M, Krasin MJ, et al. Serum ALT elevations in survivors of childhood cancer. A report from the St. Jude Lifetime Cohort Study. Hepatology, 2018 Jul 17. doi: 10.1002/hep.30176.

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    2018-10-04 shizhenshan
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    2018-08-01 gwc384
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    2018-07-30 明崖

    学习了,有用的研究

    0

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