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Gastroenterology:药物性肝损伤患者死亡风险影响因素研究

2019-07-16 MedSci MedSci原创

共病负担、终末期肝病评分和血清白蛋白水平是预测疑似DILI患者6个月的死亡率重要因素

药物性肝损伤(DILI)患者常伴有合并症,但非肝脏合并症对结局的影响未得到充分研究。近日研究人员就DILI患者的共同发病率负担和结局之间的关联进行了考察,并制定并验证了6个月内死亡风险的模型。

306名疑似DILI患者参与前瞻性研究(开发队列),考察患者6个月内与死亡独立相关的变量。另有247名疑似DILI患者的数据作为验证队列。医学共病负担采用Charlson共病指数计算,评分高于2分的患者被认为有显著的共病。

开发队列6个月死亡率为8.5%,验证队列中的死亡率为4.5%。在开发队列中,显著的共病(比值比[OR]=5.4),终末期肝病评分模型(OR=1.11),血清白蛋白水平(OR=0.39)与6个月死亡率独立相关。基于这3个变量的模型确定了6个月内死亡的患者,开发组的C统计值为0.89,验证组为0.91。

共病负担、终末期肝病评分和血清白蛋白水平是预测疑似DILI患者6个月的死亡率重要因素。

原始出处:


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    2020-04-02 许安
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  5. 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  6. [GetPortalCommentsPageByObjectIdResponse(id=1983632, encodeId=24931983632c4, content=<a href='/topic/show?id=628553048e3' target=_blank style='color:#2F92EE;'>#患者死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53048, encryptionId=628553048e3, topicName=患者死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Thu Jan 16 23:39:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712028, encodeId=7e331e120282b, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, 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  7. 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第68届美国肝病研究学会(AASLD)年会上,贾继东教授及尤红教授团队带来了涵盖慢性乙型肝炎、原发性胆汁性胆管炎、药物性肝损伤、遗传性血色病以及肝纤维化/肝硬化的多项基础和临床研究成果,内容丰富,覆盖面广。快快跟随小编一起看看都有哪些精彩内容!

Gastroenterology:中国大陆药物性肝损伤发生率及病因学的重要研究成果

近日,上海交通大学医学院附属仁济医院消化内科主任医师茅益民和中国人民解放军第85医院陈成伟教授作为共同通讯作者,在消化疾病领域顶级期刊Gastroenterology(影响因子20.773分)在线发表了题为《中国大陆药物性肝损伤发生率及病因学》(Incidence and Etiology of Drug-Induced Liver Injury in Mainland China)的研究论文引起

专访:仁济医院茅益民教授:打好基础!促进我国药物性肝损伤研究走向世界!

药物性肝损伤(drug-induced liver injury,DILI)是指由各类处方或非处方的化学药物、生物制剂、传统中药(TCM)、天然药(NM)、保健品(HP)、膳食补充剂(DS)及其代谢产物乃至辅料等所诱发的肝损伤。

2019 EASL临床实践指南:药物性肝损伤

2019年3月,欧洲肝脏研究学会(EASL)发布了药物性肝损伤指南,特异性药物肝损伤是肝病科医生面临的最具挑战的肝病之一,由于临床实践中药物种类繁多,药物性肝损伤具有多种临床和病理表型,且缺乏特定的生物标志物。本文主要总结了当前关于药物性肝损伤的危险因素、诊断、管理以及最小化风险策略的相关内容并提出指导建议。

研究人员发现治疗药物性肝损伤的新靶标:血小板反应蛋白-1

2019年实验生物学(EB)会议上报道的临床前研究结果表明,增加血小板反应蛋白-1的水平可以减轻过量对乙酰氨基酚诱导的肝损伤。

Hepatology:诊断药物性肝损伤与预后判断的候选生物标志物

在鉴别DILI患者时,GLDH似乎比miR-122更有用。K18、OPN和MCSFR等在急性DILI事件中预后价值较大。在大型前瞻性研究中对这些生物标记物的连续评估将有助于进一步描述它们在DILI诊断和管理中的作用。

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