利用剪切波弹性成像技术对重型地中海贫血患者肝纤维化进行无创评估及危险因素分析。
Noninvasive assessment and risk factors of liver fibrosis in patients with thalassemia major using shear wave elastography.
作者信息
Al-Khabori Murtadha, Daar Shahina, Al-Busafi Said A, Al-Dhuhli Humoud, Alumairi AlGhalya A, Hassan Moez, Al-Rahbi Sara, Al-Ajmi Umaima
机构信息
a Department of Haemtology , Sultan Qaboos University Hospital, Sultan Qaboos University , Muscat , Oman.
b Department of Haemtology , College of Medicine & Health Sciences Sultan Qaboos University , Muscat , Oman.
出版信息
Hematology. 2019 Dec;24(1):183-188. doi: 10.1080/10245332.2018.1540518. Epub 2018 Nov 19.
OBJECTIVES
This study aimed to estimate the prevalence of liver fibrosis and assess the risk factors for developing significant liver fibrosis in patients with Thalassemia Major (TM).
METHODS
All patients with TM over the age of 10 years were included in the study.
RESULTS
A total of 94 eligible patients underwent 2-D SWE. The median age was 26.7 years. The median of the average 5-year serum ferritin (5yrSF) and liver iron concentration (LIC) assessed by MRI T2* were 1326 µg/L and 6.7 mg/g dw, respectively. Hepatitis C and hepatitis B core antibodies were positive in 38% and 1% of the patients respectively. The proportion of patients with significant fibrosis was 60%. Male gender increased the risk of significant fibrosis (Odds ratio of 0.4; p = .0373). Additionally, the 5yrSF (p = .00661), the LIC (p = .0225) and the lowest LIC of the previous 5 years (p = .0211) were significant. In the multivariable logistic regression model, only 5yrSF (p = .0035) and gender (p = .00984) remained significant.
CONCLUSIONS
The risk of liver fibrosis is associated with iron overload and gender in patients with TM.
目的
本研究旨在评估重型地中海贫血（TM）患者肝纤维化的患病率，并评估发生显著肝纤维化的危险因素。
方法
本研究纳入了所有年龄超过10岁的TM患者。
结果
共有94例符合条件的患者接受了二维剪切波弹性成像（2-D SWE）检查。中位年龄为26.7岁。通过MRI T2*评估的5年血清铁蛋白（5yrSF）和肝脏铁浓度（LIC）的中位数分别为1326 μg/L和6.7 mg/g dw。丙型肝炎和乙肝核心抗体阳性患者分别占38%和1%。显著纤维化患者的比例为60%。男性增加了显著纤维化的风险（比值比为0.4；p = 0.0373）。此外，5yrSF（p = 0.00661）、LIC（p = 0.0225）和前5年的最低LIC（p = 0.0211）具有显著意义。在多变量逻辑回归模型中，只有5yrSF（p = 0.0035）和性别（p = 0.00984）仍然具有显著意义。
结论
TM患者肝纤维化的风险与铁过载和性别有关。
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