AJG: 血清转铁蛋白是严重酒精性肝炎死亡率的独立预测因子

2020-01-27 不详 MedSci原创

严重的酒精性肝炎(sAH)可导致严重的死亡率,但该病的病程难以预测。由于铁参数是其他肝脏疾病中有潜力预后指标,因此研究人员在本项研究中探究了它们在sAH中的预后能力。

背景及目的:
严重的酒精性肝炎(sAH)可导致严重的死亡率,但该病的病程难以预测。由于铁参数是其他肝脏疾病中有潜力预后指标,因此研究人员在本项研究中探究了它们在sAH中的预后能力。

方法:
研究人员对828名sAH患者进行了血清铁蛋白,转铁蛋白,铁,转铁蛋白饱和度,非转铁蛋白结合铁,可溶性转铁蛋白受体和铁调素的测定。将该队列随机分为探索性(n = 200)和验证集(n = 628)两部分进行验证。

结果:
sAH患者的血清转铁蛋白减少,但转铁蛋白饱和度增加。在铁参数中,基线转铁蛋白是28天(接受者操作曲线下面积为0.72 [95%置信区间0.67-0.78])和90天存活率(接受者操作特征为0.65 [0.61-0.70]下的区域)的最佳预测指标)。转铁蛋白的预测能力与综合评分相当,即终末期肝病模型,格拉斯哥酒精性肝炎评分和判别功能,并且在多变量分析中与生存率独立相关。在验证队列中证实了这些结果。

讨论:
在sAH患者中,血清转铁蛋白可预测死亡率,其性能可与常用的复合评分系统相媲美。

原始出处:
Atkinson, Stephen R. et al. Serum Transferrin Is an Independent Predictor of Mortality in Severe Alcoholic Hepatitis. American J Gastroenterology.2020.

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    2020-12-24 minzju5052
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