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肌少症对内镜治疗后并发食管胃静脉曲张的肝硬化的影响。

Effect of sarcopenia on liver cirrhosis with complicating oesophageal and gastric varices after endoscopic therapy.

机构信息

Department of Gastroenterology, PLA Rocket Force Characteristic Medical Center, Beijing, China.

Department of Gastroenterology, PLA Rocket Force Characteristic Medical Center, Beijing, China; Department of Gastroenterology, Daqing Oilfield General Hospital, Heilongjiang, China.

出版信息

Clin Res Hepatol Gastroenterol. 2024 Oct;48(8):102459. doi: 10.1016/j.clinre.2024.102459. Epub 2024 Sep 13.

Abstract

Several investigators have reported that sarcopenia is common in patients with liver cirrhosis. However, few studies have probed the association between sarcopenia and liver cirrhosis complicated with oesophageal and gastric variceal bleeding (LC-EGVB). We aimed to investigate the impact of sarcopenia on rebleeding after endoscopic therapy in patients with LC-EGVB. Computed tomography (CT) radiographs from the third lumbar vertebra were selected to analyse body composition, including skeletal muscle tissue, visceral and subcutaneous adipose tissue using SliceOmatic software. Sarcopenia was defined using validated cutoff values for patients with liver cirrhosis: 44.77 cm/m for men and 32.50 cm/m for women. A total of 187 patients with LC-EGVB and 309 controls were included in this study. The rate of sarcopenia in controls (17.4 %) was significantly lower than that in patients with LC-EGVB (41.2 %). Patients with LC-EGVB exhibiting sarcopenia showed a high prevalence of portal vein thrombosis and rebleeding rate at 1 year. The rate of sarcopenia in the rebleeding group was significantly higher than that in the non-rebleeding group. Univariate and multivariate analyses showed that sarcopenia was an independent risk factor for rebleeding within 1 year in patients with LC-EGVB. Patients with LC-EGVB displayed a high prevalence of sarcopenia. Sarcopenia was observed to be an independent risk factor for rebleeding within 1 year.

摘要

一些研究人员报告称,肝硬化患者中肌少症很常见。然而,很少有研究探讨肌少症与肝硬化合并食管胃静脉曲张出血(LC-EGVB)之间的关系。我们旨在研究肌少症对 LC-EGVB 内镜治疗后再出血的影响。从第三腰椎选择计算机断层扫描(CT)射线照片,使用 SliceOmatic 软件分析身体成分,包括骨骼肌组织、内脏和皮下脂肪组织。使用针对肝硬化患者的验证截断值定义肌少症:男性为 44.77 cm/m,女性为 32.50 cm/m。本研究共纳入 187 例 LC-EGVB 患者和 309 例对照。对照组的肌少症发生率(17.4%)明显低于 LC-EGVB 患者(41.2%)。LC-EGVB 伴有肌少症的患者门静脉血栓形成和 1 年内再出血率较高。再出血组的肌少症发生率明显高于非再出血组。单因素和多因素分析显示,肌少症是 LC-EGVB 患者 1 年内再出血的独立危险因素。LC-EGVB 患者肌少症的患病率较高。肌少症被观察到是 LC-EGVB 患者 1 年内再出血的独立危险因素。

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