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印度南部一家三级医疗医院慢性肝病患者的血清尿酸水平及其与Child-Pugh评分的相关性

Serum uric acid level in chronic liver disease and its correlation with Child-Pugh score in a tertiary care hospital from South India.

作者信息

Noklang Samuel, Noklang Imjungba, Chirumamilla Sri Sai Kaumudi, Kannauje Pankaj K

机构信息

Department of General Medicine, Zion Hospital and Research Centre, Dimapur, Nagaland, India.

Department of General Medicine, Dr Imkongliba Memorial District Hospital (IMDH), Mokokchung, Nagaland, India.

出版信息

J Family Med Prim Care. 2023 Nov;12(11):2696-2701. doi: 10.4103/jfmpc.jfmpc_847_23. Epub 2023 Nov 21.

Abstract

BACKGROUND

Chronic liver disease (CLD) is one of the important causes of morbidity and mortality in our country, and since the damage to the liver is irreversible, we have to look for many severity markers or predictors for the prognosis of the patient. In this study, we have tried to correlate the level of serum uric acid (UA) with the severity of CLD presented as a Child-Pugh score.

METHODS

A cross-sectional observational study was conducted at Vijayanagar Institute of Medical Science (VIMS), Ballari, Karnataka, from October 2015 to June 2017 in the Department of General Medicine. Fifty patients diagnosed with CLD, aged between 18 and 65 years, of either gender, were enrolled in the study. Serum UA levels were measured, and liver function and coagulation parameters were assessed. A statistical analysis was performed to evaluate the association between serum UA levels, liver function test, and coagulation parameters.

RESULTS

In our study, the mean serum UA level was 6.52 mg/dl and was raised in patients with CLD in correlation to its severity. Alcoholic liver disease (ALD) was the most common etiology for CLD (80%) followed by hepatitis B (Hep B) virus infection (12%) and hepatitis C (Hep C) virus infection (6%). Serum UA levels increased as the Child-Turcotte-Pugh (CTP) score increased. The mean UA level in CTP class C was 8.29 mg/dl. Various parameters such as serum aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase, total bilirubin, international normalized ratio (INR), calcium, and albumin were significantly associated with serum UA levels in CLD patients.

CONCLUSION

The correlation between rising blood UA levels and the Child-Pugh score shows that UA estimate may be a valid and affordable indicator for assessing the extent of liver cirrhosis in CLD.

摘要

背景

慢性肝病(CLD)是我国发病和死亡的重要原因之一,由于肝脏损伤是不可逆的,我们必须寻找多种严重程度标志物或患者预后的预测指标。在本研究中,我们试图将血清尿酸(UA)水平与以Child-Pugh评分表示的CLD严重程度相关联。

方法

2015年10月至2017年6月在卡纳塔克邦巴拉里市维贾亚纳加尔医学科学研究所(VIMS)普通内科进行了一项横断面观察研究。纳入了50例年龄在18至65岁之间、性别不限、诊断为CLD的患者。测量血清UA水平,并评估肝功能和凝血参数。进行统计分析以评估血清UA水平、肝功能试验和凝血参数之间的关联。

结果

在我们的研究中,平均血清UA水平为6.52mg/dl,并且在CLD患者中随着其严重程度而升高。酒精性肝病(ALD)是CLD最常见的病因(80%),其次是乙型肝炎(乙肝)病毒感染(12%)和丙型肝炎(丙肝)病毒感染(6%)。血清UA水平随着Child-Turcotte-Pugh(CTP)评分增加而升高。CTP C级的平均UA水平为8.29mg/dl。各种参数如血清天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、碱性磷酸酶、总胆红素、国际标准化比值(INR)、钙和白蛋白与CLD患者的血清UA水平显著相关。

结论

血UA水平升高与Child-Pugh评分之间的相关性表明,UA评估可能是评估CLD中肝硬化程度的有效且经济实惠的指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22db/10771220/a22993a2bda6/JFMPC-12-2696-g001.jpg

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