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[经肝活检确诊的早期肝硬化患者临床及实验室数据的五年随访]

[Five-year follow-up of clinical and laboratory data of early liver cirrhosis patients confirmed by liver biopsy].

作者信息

Kim Dong Uk, Park Geun Tae, Koh Dong Hee, Cho Hyun Seok, Kim Young Hoon, Shim Sung Gon, Kim Jin Bae, Lee Sung Hee, Choi Ho Soon, Hahm Joon Soo, Lee Min Ho

机构信息

Research Institute of Digestive Disease, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

出版信息

Taehan Kan Hakhoe Chi. 2002 Sep;8(3):256-63.

Abstract

BACKGROUND/AIMS: It is important to evaluate the general status of the liver including the structural and inflammatory aspects, as well as the functional aspects, in order to determine a patient's treatment modality and prognosis.

METHODS

55 Child-Pugh class A liver cirrhosis patients confirmed by liver biopsy have been categorized into 4 groups based on the shunt index and p-value(Y= 3.3431-0.8160 ALT/AST ratio-0.0343 X prothrombin time+2.6963 X shunt index, p = e(y)/(e(y)+1)), which was obtained by Thallium- 201 scan; group I - shunt index less than 0.3 and p-value less than 0.7; group II - shunt index less than 0.3 and p-value more than 0.7; group III - shunt index more than 0.3 and p-value less than 0.7; and group IV - shunt index more than 0.3 and p-value more than 0.7. Statistical analyses used were ANOVA, paired t-test, and Chi-square test.

RESULTS

  1. The laboratory data after a 5-year follow-up also showed a significant difference between four groups. 2. In group IV, the Child-Pugh class after 5 years worsened, and complications of liver cirrhosis such as esophageal varix, ascites, and hepatic encephalopathy occurred more frequently. 3. In group II, the laboratory data after a 5-year follow-up indicated some improvement.

CONCLUSION

It can be seen that even early in patients with initially the same cirrhosis, the course of the illness can progress to a variety of different situations. The measurement of shunt index and the p-value of cirrhosis will be more helpful in the follow-up evaluation and predicting its prognostic index in liver cirrhosis patients.

摘要

背景/目的:评估肝脏的总体状况,包括结构和炎症方面以及功能方面,对于确定患者的治疗方式和预后很重要。

方法

55例经肝活检确诊为Child-Pugh A级肝硬化的患者,根据通过铊-201扫描获得的分流指数和p值(Y = 3.3431 - 0.8160×谷丙转氨酶/谷草转氨酶比值 - 0.0343×凝血酶原时间 + 2.6963×分流指数,p = e(y)/(e(y)+1))分为4组;I组 - 分流指数小于0.3且p值小于0.7;II组 - 分流指数小于0.3且p值大于0.7;III组 - 分流指数大于0.3且p值小于0.7;IV组 - 分流指数大于0.3且p值大于0.7。所采用的统计分析方法为方差分析、配对t检验和卡方检验。

结果

  1. 5年随访后的实验室数据也显示4组之间存在显著差异。2. 在IV组中,5年后Child-Pugh分级恶化,肝硬化并发症如食管静脉曲张、腹水和肝性脑病的发生频率更高。3. 在II组中,5年随访后的实验室数据显示有一些改善。

结论

可以看出,即使在最初肝硬化程度相同的患者中,疾病进程也可能发展为多种不同情况。测量肝硬化的分流指数和p值将更有助于对肝硬化患者进行随访评估并预测其预后指数。

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