Liver Transpl:肝移植术后脂肪变性研究

2016-04-09 Mechront 译 MedSci原创

捷克布拉格临床与实验医学机构肝胆胃肠病学的Irena Hejlová博士和同事对548名肝移植受体进行了2360次肝移植术后肝脏活检,比较明显脂肪变性和0-1级脂肪变性患者的生存。研究结果发表在近期的Liver Transpl。结果显示,56.4%的患者有脂肪变性(n = 309),其中17%的患者显著脂肪变性(n = 93)。肝移植术后1年到10年,脂肪变形的发生率从30.3%增加到47%(P

捷克布拉格临床与实验医学机构肝胆胃肠病学的Irena Hejlová博士和同事对548名肝移植受体进行了2360次肝移植术后肝脏活检,比较明显脂肪变性和0-1级脂肪变性患者的生存。研究结果发表在近期的Liver Transpl

结果显示,56.4%的患者有脂肪变性(n = 309),其中17%的患者显著脂肪变性(n = 93)。肝移植术后1年到10年,脂肪变性的发生率从30.3%增加到47%(P < .001)。虽然移植术后的脂肪变性并不会对几年内的生存造成影响,但是长远来看,脂肪变性具有恶化生存的趋势。

研究者还发现,肝移植术后随着时间的变迁,脂肪变性的发生率变化不大(P = .85)。

对移植前因素和最初的免疫抑制进行多因素分析显示,酒精介导的肝硬化(P < .001)和高的BMI值(P = .002)与显著脂肪变性的发展相关。而碱性磷酸酶水平的升高(P = .01)和最初使用霉酚酸酯(P = .009)对显著脂肪变性其保护作用。

对移植后因素进行多因素分析显示,高BMI值(P < .001)、血清甘油三酯水平(P < .001)、酒精摄入量(P = .005)和2型糖尿病(P = .048)与显著脂肪变性相关。高肌酐水平则对其有保护作用(P = .02)。

不过研究者没有发现,显著脂肪变性与更高级别纤维化间的关联(P = .62)。

为避免脂肪变形发展为脂肪肝,作者认为应该鼓励患者进行运动,避免肥胖,此外还需要对糖尿病和高脂血症等进行筛查,还有,肝移植受体病人应该避免饮酒。

原始出处:


Hejlová I, et al. Prevalence and risk factors of steatosis after liver transplantation and patient outcomes.Liver Transpl. 2016;doi:10.1002/lt.24393.

Post-liver transplant steatosis increases over time.Healio.April 7, 2016


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    2016-05-24 bsmagic9140
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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Sun Apr 10 10:02:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76621, encodeId=59d5e66216d, content=学习了,运动有助于治疗很多病, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00531550470, createdName=layyjiangli, createdTime=Sat Apr 09 20:19:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76582, encodeId=9b65e658270, content=值得研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sat Apr 09 13:17:00 CST 2016, time=2016-04-09, status=1, ipAttribution=)]
    2016-09-16 1e10c84am36(暂无匿称)

    不错哦,会学到很多

    0

  5. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Sun Apr 10 10:02:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76621, encodeId=59d5e66216d, content=学习了,运动有助于治疗很多病, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00531550470, createdName=layyjiangli, createdTime=Sat Apr 09 20:19:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76582, encodeId=9b65e658270, content=值得研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sat Apr 09 13:17:00 CST 2016, time=2016-04-09, status=1, ipAttribution=)]
    2016-04-14 李继凯

    高大上的文章

    0

  6. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Sun Apr 10 10:02:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76621, encodeId=59d5e66216d, content=学习了,运动有助于治疗很多病, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00531550470, createdName=layyjiangli, createdTime=Sat Apr 09 20:19:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76582, encodeId=9b65e658270, content=值得研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sat Apr 09 13:17:00 CST 2016, time=2016-04-09, status=1, ipAttribution=)]
    2016-04-11 huangdf
  7. 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sat Apr 09 13:17:00 CST 2016, time=2016-04-09, status=1, ipAttribution=)]
    2016-04-10 hekzn

    好好学习

    0

  8. 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topicList=[TopicDto(id=38128, encryptionId=7d27381288e, topicName=变性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f69f6545041, createdName=huangdf, createdTime=Mon Apr 11 03:48:00 CST 2016, time=2016-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76670, encodeId=45eee667059, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJJAFMgSjibMicGVUgkmDBw4svXiccQxZicwjRHNxGPTghAmITxP12Rcmm0yFKfwGwUaiaUwpPUUUTOd2g/0, createdBy=fcd21609070, createdName=hekzn, createdTime=Sun Apr 10 13:42:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76644, encodeId=b5dde6644b1, content=移植和不移植的如果有对比就更好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=172, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Sun Apr 10 10:02:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76621, encodeId=59d5e66216d, content=学习了,运动有助于治疗很多病, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00531550470, createdName=layyjiangli, createdTime=Sat Apr 09 20:19:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76582, encodeId=9b65e658270, content=值得研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sat Apr 09 13:17:00 CST 2016, time=2016-04-09, status=1, ipAttribution=)]
    2016-04-10 lyh994

    移植和不移植的如果有对比就更好了

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1998900, encodeId=bf8a1998900da, content=<a href='/topic/show?id=8e2ee5200ee' target=_blank style='color:#2F92EE;'>#移植术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75200, encryptionId=8e2ee5200ee, topicName=移植术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63a4277, createdName=cy0324, createdTime=Wed May 18 00:48:00 CST 2016, time=2016-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1948756, encodeId=5de41948e567a, content=<a href='/topic/show?id=0602843360f' target=_blank style='color:#2F92EE;'>#脂肪变性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84336, encryptionId=0602843360f, topicName=脂肪变性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=346311, 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topicList=[TopicDto(id=38128, encryptionId=7d27381288e, topicName=变性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f69f6545041, createdName=huangdf, createdTime=Mon Apr 11 03:48:00 CST 2016, time=2016-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76670, encodeId=45eee667059, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJJAFMgSjibMicGVUgkmDBw4svXiccQxZicwjRHNxGPTghAmITxP12Rcmm0yFKfwGwUaiaUwpPUUUTOd2g/0, createdBy=fcd21609070, createdName=hekzn, createdTime=Sun Apr 10 13:42:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76644, encodeId=b5dde6644b1, content=移植和不移植的如果有对比就更好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=172, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Sun Apr 10 10:02:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76621, encodeId=59d5e66216d, content=学习了,运动有助于治疗很多病, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00531550470, createdName=layyjiangli, createdTime=Sat Apr 09 20:19:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76582, encodeId=9b65e658270, content=值得研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sat Apr 09 13:17:00 CST 2016, time=2016-04-09, status=1, ipAttribution=)]
    2016-04-09 layyjiangli

    学习了,运动有助于治疗很多病

    0

  10. 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topicList=[TopicDto(id=38128, encryptionId=7d27381288e, topicName=变性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f69f6545041, createdName=huangdf, createdTime=Mon Apr 11 03:48:00 CST 2016, time=2016-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76670, encodeId=45eee667059, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJJAFMgSjibMicGVUgkmDBw4svXiccQxZicwjRHNxGPTghAmITxP12Rcmm0yFKfwGwUaiaUwpPUUUTOd2g/0, createdBy=fcd21609070, createdName=hekzn, createdTime=Sun Apr 10 13:42:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76644, encodeId=b5dde6644b1, content=移植和不移植的如果有对比就更好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=172, replyNumber=0, topicName=null, 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sat Apr 09 13:17:00 CST 2016, time=2016-04-09, status=1, ipAttribution=)]
    2016-04-09 1de3b290m83(暂无匿称)

    值得研究

    0

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背景:肝移植术(LT)是治疗早期肝癌(HCC)伴肝硬化的最佳治疗方法。然而,器官紧缺而引起的等待时间较长,另外由于肿瘤进展与恶化,其意向治疗(ITT)的生存效果较差。门脉高压症(PH)是早期肝癌伴肝硬化以及肝移植术后复发的进程中公认的危险因素。目的:本研究的目的是评价门静脉高压症对于肝移植术后基于ITT治疗的结局的潜在影响。方法:招募因肝细胞癌而行肝移植的肝硬化病例,收集其结局和是否存在门静脉高压

Pediatrics:自身免疫性肝炎的发病率和特征

自身免疫性肝炎 (AIH) 是由自身免疫反应介导的慢性进行性肝脏炎症性疾病,目前病因不明。根据血清自身抗体可将A IH分为3型,Ⅰ型AIH最为常见,相关抗体为ANA和(或)SMA;Ⅱ型A IH的特征为抗- LKM1阳性;Ⅲ型A IH的特征为血清抗- SLA /LP阳性,有学者将Ⅲ型归为Ⅰ型。研究者进行了一项研究探究了加拿大儿童AIH的发病率以及临床表现。该回顾性队列研究纳入了加拿大所有儿科中心20

Hepatology:三种药物联合治疗肝硬化或肝移植的HCV感染者(ALLY-1)

对慢性丙型肝炎病毒(HCV)感染伴晚期肝硬化或肝移植术后复发的患者,当前并没有针对所有HCV基因型的有效治疗方案。研究者进行了一项研究(ALLY-1),评估每天一次达卡他韦60 mg(泛基因型NS5A抑制剂)+索非布韦400 mg(NS5A抑制剂)+利巴韦林600 mg,对慢性HCV(任何基因型)感染伴肝硬化(代偿或失代偿)或肝移植术后复发的患者的疗效(12周的治疗时间,24周的随访时间)。移植患