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原发性胆汁性肝硬化患者的丙型肝炎病毒感染。

Hepatitis C virus infection in patients with primary biliary cirrhosis.

机构信息

Division of Gastroenterology & Hepatology, Tri-Service General Hospital, National Defense Medical Center, Taiwan.

出版信息

Ann Hepatol. 2013 Jan-Feb;12(1):78-84.

Abstract

BACKGROUND AND AIM

The aim of this study is to evaluate the role of hepatitis C virus (HCV) infection in patients with primary biliary cirrhosis (PBC).

MATERIAL AND METHODS

On the basis of a retrospective review of medical records, all patients consecutively diagnosed with PBC or HCV infection between 1999 and 2011 and who had a regular follow-up of at least 3 years were included in the study. Clinical characteristics, especially the severity of cirrhosis, were analyzed in PBC patients with HCV infection (PBC-HCV), PBC patients without HCV infection (PBC-only), and patients with only HCV infection (HCV-only).

RESULTS

A total of 76 patients with PBC, including 9 patients with HCV infection, were analyzed. Of the PBC-HCV patients, 7 (7/9, 77.8%) were women with a mean age of 55.11 ± 14.29 years. Age- and sex-matched PBC-only patients (n = 36) and HCV-only patients (n = 36) were used as control groups. In comparison to the PBC-only controls, PBC-HCV patients had a greater severity of cirrhosis based on Child-Pugh (p = 0.019) and Model for End-Stage Liver Disease (MELD) (p = 0.01) scores. However, no significant difference in the severity of cirrhosis was found between the PBC-HCV and HCV-only control patients (p = 0.94 in Child-Pugh scores; p = 0.64 in MELD scores).

CONCLUSIONS

In PBC patients with concomitant HCV infection, aggressive management may be warranted in view of the associated more severe liver cirrhosis.

摘要

背景与目的

本研究旨在评估丙型肝炎病毒(HCV)感染在原发性胆汁性肝硬化(PBC)患者中的作用。

材料与方法

基于对病历的回顾性分析,本研究纳入了 1999 年至 2011 年间连续诊断为 PBC 或 HCV 感染且随访时间至少 3 年的患者。分析了 HCV 感染的 PBC 患者(PBC-HCV)、无 HCV 感染的 PBC 患者(PBC-only)和单纯 HCV 感染患者(HCV-only)的临床特征,尤其是肝硬化的严重程度。

结果

共分析了 76 例 PBC 患者,其中 9 例合并 HCV 感染。9 例 PBC-HCV 患者中,7 例(7/9,77.8%)为女性,平均年龄为 55.11±14.29 岁。将年龄和性别匹配的 PBC-only 患者(n=36)和 HCV-only 患者(n=36)作为对照组。与 PBC-only 对照组相比,PBC-HCV 患者的肝硬化严重程度根据 Child-Pugh(p=0.019)和终末期肝病模型(MELD)评分更高(p=0.01)。然而,PBC-HCV 患者与 HCV-only 对照组患者的肝硬化严重程度无显著差异(Child-Pugh 评分:p=0.94;MELD 评分:p=0.64)。

结论

鉴于合并 HCV 感染的 PBC 患者可能存在更严重的肝硬化,需要积极治疗。

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