Clin Trans Gastro: 肌肉减少症与接受经颈静脉肝内门体分流术的失代偿肝硬化急性慢性肝功能衰竭的发生有关

2019-05-20 不详 MedSci原创

肌肉质量已被证明是肝硬化患者的预后标志物。肌肉减少症可以通过CT扫描获得的横向腰肌肌肉厚度通过身高(TPMT /身高)进行简单换算。它与急性慢性肝衰竭(ACLF)的关系尚未确定。ACLF与全身性炎症失调有关。本研究旨在评估肌肉减少症在接受经颈静脉肝内门体分流术(TIPS)的失代偿期肝硬化患者ACLF发展中的预测作用。

背景及目的:
肌肉质量已被证明是肝硬化患者的预后标志物。肌肉减少症可以通过CT扫描获得的横向腰肌肌肉厚度通过身高(TPMT /身高)进行简单换算。它与急性慢性肝衰竭(ACLF)的关系尚未确定。ACLF与全身性炎症失调有关。本研究旨在评估肌肉减少症在接受经颈静脉肝内门体分流术(TIPS)的失代偿期肝硬化患者ACLF发展中的预测作用。

方法:
研究人员分析了 接受TIPS手术的 186名患者的临床资料。TPMT /身高是从常规计算机断层扫描测量的,根据结果将患者分类为肌肉减少症和非肌肉减少症组。比较临床结果。主要观察终点是TIPS后的ACLF的发生率和1年死亡率。次要终点是TIPS后失代偿(肝性脑病和腹水)出现。

结果:
性别特异性截止值提高了主要和次要终点的诊断准确性。性别特异性肌肉减少症分类是接受TIPS的肝硬化患者1年死亡率和ACLF发展的独立预测因子。与非肌肉减少症组相比,肌肉减少症组的患者在TIPS后显示出显着更高的死亡率,腹水,明显肝性脑病和ACLF。慢性肝衰竭联合会急性失代偿评分作为全身炎症的标志物显着高于肌肉减少症患者。

结论:
本研究首次证实肌肉减少症与ACLF发展和全身炎症有关。通过使用性别特异性截止值可以改善TPMT /身高的预后价值

原始出处:

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    2020-01-29 bsmagic9140
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  4. 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topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Thu Jun 06 16:42:00 CST 2019, time=2019-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697906, encodeId=19c7169e906c3, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Wed Nov 20 09:42:00 CST 2019, time=2019-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647472, encodeId=bb22164e47273, content=<a href='/topic/show?id=9e7fe8501bb' target=_blank 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  5. 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topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Wed May 22 09:42:00 CST 2019, time=2019-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393390, encodeId=6e2b139339053, content=<a href='/topic/show?id=e2f4809e7e9' target=_blank style='color:#2F92EE;'>#肌肉减少症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80977, encryptionId=e2f4809e7e9, topicName=肌肉减少症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIOca9icPByKxo3ZRUrvuibf7tWt7EScQ1NEiaKy4NCUctSU2jDjOayLicDIaicwUxaQhJ1SZKdEevgjRg/132, createdBy=4f272500131, createdName=若水123, createdTime=Wed May 22 09:42:00 CST 2019, time=2019-05-22, status=1, ipAttribution=)]
    2019-11-20 fusion
  6. 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  7. 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style='color:#2F92EE;'>#经颈静脉肝内门体分流术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78501, encryptionId=9e7fe8501bb, topicName=经颈静脉肝内门体分流术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21e623422994, createdName=zhaozhouchifen, createdTime=Tue May 28 02:42:00 CST 2019, time=2019-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072570, encodeId=c00620e257092, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Aug 30 15:42:00 CST 2019, time=2019-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1815168, encodeId=b99e1815168f6, content=<a href='/topic/show?id=7b2d9e097b7' target=_blank style='color:#2F92EE;'>#门体分流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97097, encryptionId=7b2d9e097b7, topicName=门体分流)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/lGEyfsKnIkkH93xUPMrUUycLh2XOfJJsphwPsVqDx8somSOepIFy9QE0MVAwDW3AS7V1epJ4tbPL9ADJLicvm8A/132, createdBy=b5132500067, createdName=ms55066533437992, createdTime=Mon Mar 16 01:42:00 CST 2020, time=2020-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366719, encodeId=8f1a1366e1958, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Wed May 22 09:42:00 CST 2019, time=2019-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393390, encodeId=6e2b139339053, content=<a href='/topic/show?id=e2f4809e7e9' target=_blank style='color:#2F92EE;'>#肌肉减少症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80977, encryptionId=e2f4809e7e9, topicName=肌肉减少症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIOca9icPByKxo3ZRUrvuibf7tWt7EScQ1NEiaKy4NCUctSU2jDjOayLicDIaicwUxaQhJ1SZKdEevgjRg/132, createdBy=4f272500131, createdName=若水123, createdTime=Wed May 22 09:42:00 CST 2019, time=2019-05-22, status=1, ipAttribution=)]
    2019-08-30 许安
  8. 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  9. 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