Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Sci Rep. 2021 Oct 14;11(1):20479. doi: 10.1038/s41598-021-99855-z.
Liver function is a most important prognostic factor in patients with liver cirrhosis. Also, portal hypertension is a fatal complication of liver cirrhosis and variceal treatment is indispensable. However, changes of liver functions after endoscopic variceal treatments are unknown. The aim of this study was to evaluate prognosis and liver functions after endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL). A total of liver cirrhotic 103 patients who underwent prophylactic EIS and EVL were enrolled. Overall survival rate was higher in EIS group than EVL group (p = 0.03). Multivariate analysis showed that EIS was a negative factor for death (HR: 0.46, 95% confidence interval: 0.24-0.88, p = 0.02). Liver functions were assessed by blood test taken at before and 3 months after treatment. In EIS group, albumin and prothrombin time improved (p < 0.01), leading to improvement of Child-Pugh score, ALBI score and MELD score (p < 0.05). However, these did not improve in EVL group. EIS was a significant factor related to the elevated value of albumin after treatment in linear regression analysis (estimated regression coefficient: 0.17, 95% confidence interval: 0.05-0.29, p = 0.005). These results revealed that EIS could improve liver functions and prognosis.
肝功能是肝硬化患者最重要的预后因素。此外，门静脉高压是肝硬化的致命并发症，必须进行静脉曲张治疗。然而，内镜下静脉曲张治疗后肝功能的变化尚不清楚。本研究旨在评估内镜下硬化治疗（EIS）和内镜下套扎治疗（EVL）后的预后和肝功能。共纳入 103 例接受预防性 EIS 和 EVL 的肝硬化患者。EIS 组的总生存率高于 EVL 组（p=0.03）。多因素分析显示，EIS 是死亡的负相关因素（HR：0.46，95%置信区间：0.24-0.88，p=0.02）。治疗前和治疗后 3 个月通过血液检查评估肝功能。EIS 组白蛋白和凝血酶原时间改善（p<0.01），导致 Child-Pugh 评分、ALBI 评分和 MELD 评分改善（p<0.05）。然而，EVL 组这些指标没有改善。线性回归分析显示，EIS 是治疗后白蛋白升高的显著相关因素（估计回归系数：0.17，95%置信区间：0.05-0.29，p=0.005）。这些结果表明，EIS 可改善肝功能和预后。
