肝病与慢性瘙痒的关联：一项病例对照研究。
Association of Liver Disease and Chronic Pruritus: A Case-Control Study.
作者信息
Andrade Luis F, Haq Zaim, Abdi Parsa, Diaz Michael J, Levy Cynthia, Yosipovitch Gil
机构信息
Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
出版信息
Liver Int. 2025 Apr;45(4):e16126. doi: 10.1111/liv.16126. Epub 2024 Oct 18.
BACKGROUND & METHODS: Through the identification of 22 803 cases of chronic pruritus, with a control group comprising 91 212 participants from a national database, we performed a comparative analysis revealing that patients with chronic pruritus had a significantly higher prevalence of liver disease compared to controls.
RESULTS
Upon reverse analysis, we similarly found patients with liver disease had a significantly higher prevalence of chronic pruritus. Subsequent multivariate logistic regression highlighted increased odds for several liver diseases in the pruritus cohort, including metabolic dysfunction-associated steatotic liver disease (aOR 1.65, 95% CI 1.53-1.78) and alcohol-related liver disease (aOR 1.69, 95% CI 1.43-1.98). The increased odds were most pronounced for hepatitis B (aOR 2.01, 95% CI 1.67-2.42) and cholangitis + primary sclerosing cholangitis + primary biliary cholangitis (aOR 1.81, 95% CI 1.65-1.99).
CONCLUSION
Our results reveal a strong correlation between pruritus in hepatic pathologies different than commonly reported cholestatic diseases.
背景与方法
通过对22803例慢性瘙痒病例进行识别，并以一个国家数据库中的91212名参与者作为对照组，我们进行了一项对比分析，结果显示与对照组相比，慢性瘙痒患者的肝病患病率显著更高。
结果
在反向分析中，我们同样发现肝病患者的慢性瘙痒患病率显著更高。随后的多因素逻辑回归分析显示，瘙痒队列中几种肝病的患病几率增加，包括代谢功能障碍相关脂肪性肝病（调整后比值比1.65，95%置信区间1.53 - 1.78）和酒精性肝病（调整后比值比1.69，95%置信区间1.43 - 1.98）。乙肝（调整后比值比2.01，95%置信区间1.67 - 2.42）以及胆管炎 + 原发性硬化性胆管炎 + 原发性胆汁性胆管炎（调整后比值比1.81，95%置信区间1.65 - 1.99）的患病几率增加最为明显。
结论
我们的研究结果揭示了瘙痒与不同于常见胆汁淤积性疾病的肝脏病变之间存在密切关联。
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