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肝硬化尸体供肝者肝脏病变严重程度与椎体微观结构恶化相关。

The severity of hepatic disorder is related to vertebral microstructure deterioration in cadaveric donors with liver cirrhosis.

机构信息

Laboratory for Anthropology and Skeletal biology, Institute for Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Institute of Forensic Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

出版信息

Microsc Res Tech. 2021 May;84(5):840-849. doi: 10.1002/jemt.23642. Epub 2020 Nov 10.

DOI:10.1002/jemt.23642
PMID:33170963
Abstract

Patients with liver cirrhosis (LC) commonly suffer from osteoporosis and vertebral fracture, but data about their vertebral micro-architectural changes are still limited. This study aimed to evaluate the potential differences in trabecular micro-architecture of lumbar vertebrae between male LC patients and healthy controls, in relation to etiology and pathohistological scoring of the liver disorder. After pathohistological examination of liver tissue, micro-computed tomography was performed on the vertebral samples included into: alcoholic liver cirrhosis group (ALC; n = 16; age: 59 ± 8 years), non-alcoholic liver cirrhosis group (non-ALC; n = 15; age: 69 ± 10 years) and control group (n = 16; age: 58 ± 6 years). Our data showed significant impairment of the trabecular microstructure in the lumbar vertebrae from LC donors, regardless of the alcoholic/non-alcoholic origin of liver disorder, as illustrated by lower BV/TV, Tb.Th, and Tb.N compared with controls (p < .05). Moreover, depredation in trabecular micro-architecture was inversely associated with pathohistological scores (p < .05), indicating that severity of liver disorder could be an important predictor of reduced vertebral strength in LC. We noticed significant micro-architectural deterioration in the trabecular compartment of the lumbar vertebrae of male individuals with alcoholic and non-alcoholic LC, which was associated with the severity of the liver disease. Thus, clinical assessment of fracture risk should be advised for all LC patients, regardless of the alcoholic origin of liver cirrhosis. Additionally, adequate and timely treatment of liver disorder may decelerate the progression of bone impairment in LC patients.

摘要

肝硬化(LC)患者常患有骨质疏松症和椎体骨折,但有关其椎骨微观结构变化的数据仍然有限。本研究旨在评估男性 LC 患者与健康对照组之间腰椎小梁微观结构的潜在差异,同时考虑肝脏疾病的病因和组织病理学评分。在对肝组织进行组织病理学检查后,对纳入的椎骨样本进行了微计算机断层扫描:酒精性肝硬化组(ALC;n = 16;年龄:59 ± 8 岁)、非酒精性肝硬化组(非-ALC;n = 15;年龄:69 ± 10 岁)和对照组(n = 16;年龄:58 ± 6 岁)。我们的数据表明,无论肝脏疾病的酒精/非酒精起源如何,LC 供体的腰椎小梁微观结构都明显受损,与对照组相比,BV/TV、Tb.Th 和 Tb.N 均较低(p <.05)。此外,小梁微观结构的破坏与组织病理学评分呈负相关(p <.05),表明肝脏疾病的严重程度可能是 LC 椎体强度降低的重要预测因素。我们注意到,男性酒精性和非酒精性 LC 患者的腰椎小梁结构明显恶化,这与肝脏疾病的严重程度有关。因此,无论肝硬化的酒精性起源如何,都应为所有 LC 患者提供骨折风险的临床评估。此外,及时和充分的肝脏疾病治疗可能会减缓 LC 患者的骨损伤进展。

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