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Gut:经活检证实的酒精相关肝病患者死亡率

2020-03-29 MedSci原创 MedSci原创

经活检证实的ALD患者死亡风险是普通人群的5倍。没有肝硬化的ALD患者也有较高的死亡风险,因此,有必要重申在治疗这些患者时,需要提高警惕。

酒精相关肝病(ALD)患者的死亡风险增加,但很少有研究调查组织学严重程度的重要性,或与一般人群相比,估计其相对风险。近日,消化病领域权威杂志Gut上发表了一篇研究文章,研究人员评估了全国范围内经活检证实的ALD的死亡率。

在瑞典进行的以人群为基础的队列研究中,有3453人在1969年至2017年期间接受了肝脏活检,诊断为国际肝病分类(ICD)的ALD,并与16535名一般人群中的参与者相匹配。研究人员使用瑞典国家登记册确定总体和疾病特异性死亡率,从首次ICD诊断或肝活检后3个月开始随访。Cox回归校正相关混杂因素,并用于评估ALD和组织病理学亚组的HRs。

受试者中位年龄为58岁,65%为男性,52%在基线时有肝硬化。ALD患者的5年累积死亡率为40.9%,而对照个体为5.8%。总死亡率的风险显著增加(调整HR (aHR)=4.70, 95%CI为4.35至5.08)。与肝脏相关的死亡风险尤其高(占所有死亡的43%,aHR=167.6, 95%CI为101.7至276.3)。无肝硬化的ALD患者的死亡率也显著增加,在基线后的第一年最高,但在≥10年随访后仍持续(aHR=2.74, 95%CI为2.37至3.16)。

由此可见,经活检证实的ALD患者死亡风险是普通人群的5倍。没有肝硬化的ALD患者也有较高的死亡风险,因此,有必要重申在治疗这些患者时,需要提高警惕。

原始出处:

Hannes Hagström.et al.Mortality in biopsy-proven alcohol-related liver disease: a population-based nationwide cohort study of 3453 patients. Gut.2020.http://dx.doi.org/10.1136/gutjnl-2019-320446

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    2020-04-04 飛歌

    学习了很有用不錯

    0

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