Hoevenaren Inge A, Wester Ruth, Schrier Robert W, McFann Kim, Doctor R Brian, Drenth Joost P H, Everson Gregory T
Department of Medicine, Division of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Liver Int. 2008 Feb;28(2):264-70. doi: 10.1111/j.1478-3231.2007.01595.x. Epub 2007 Oct 9.
The goal of this study was to compare the clinical features of patients with isolated polycystic liver disease (PCLD) with those of patients with polycystic liver and autosomal dominant polycystic kidney disease (ADPKD).
Cases were identified from clinical records at the University of Colorado Hospital in Denver (USA) and at the Radboud University Hospital in Nijmegen (the Netherlands) by ICD-10 codes. To be included in this analysis, patients had to have an initial diagnosis of PCLD within six years of presentation to our clinics. Medical records were reviewed for demographic information, medical history, physical examination, symptoms, complications, laboratory and imaging results, therapy and outcomes.
Out of a total of 94, 53 patients met our criteria for entering this study, 19 with PCLD and 34 with ADPKD. The mean time interval from diagnosis of PCLD to presentation in our clinics was 1.21 years for PCLD and 2.76 years for ADPKD (P=NS). PCLD was associated with female gender in both PCLD and ADPKD. Patients with PCLD had greater numbers (P=0.031), and larger sizes of liver cysts (P=0.0051), but had less associated morbidities than patients with ADPKD. Liver cyst decompressions were performed more frequently in PCLD patients (57.9 vs. 23.5%, P=0.012). However, serious hepatic complications, sufficient to require consideration of liver transplantation, were more frequent in patients with ADPKD (0/19 vs. 6/34, P<0.0001).
Although PCLD in patients with PCLD is characterized by larger and greater number of hepatic cysts, the clinical course is relatively benign compared with ADPKD.
本研究的目的是比较孤立性多囊肝病(PCLD)患者与多囊肝合并常染色体显性多囊肾病(ADPKD)患者的临床特征。
通过国际疾病分类第十版(ICD - 10)编码,从美国丹佛市科罗拉多大学医院和荷兰奈梅亨市拉德堡德大学医院的临床记录中识别病例。纳入本分析的患者必须在就诊于我们诊所的六年内首次诊断为PCLD。查阅病历以获取人口统计学信息、病史、体格检查、症状、并发症、实验室和影像学检查结果、治疗及预后情况。
在总共94例患者中,53例符合我们进入本研究的标准,其中19例为PCLD患者,34例为ADPKD患者。PCLD患者从诊断到就诊于我们诊所的平均时间间隔为1.21年,ADPKD患者为2.76年(P = 无显著性差异)。PCLD在PCLD和ADPKD患者中均与女性性别相关。PCLD患者的肝囊肿数量更多(P = 0.031)、体积更大(P = 0.0051),但与ADPKD患者相比,合并的疾病更少。PCLD患者更频繁地接受肝囊肿减压治疗(57.9%对23.5%,P = 0.012)。然而,足以需要考虑肝移植的严重肝脏并发症在ADPKD患者中更常见(0/19对6/34,P < 0.0001)。
尽管PCLD患者的PCLD以更大数量和更大体积的肝囊肿为特征,但与ADPKD相比,临床病程相对良性。