Hepatology:肝纤维化FIB-4分期可预测HIV感染与非感染者心力衰竭风险

2017-06-08 MedSci MedSci原创

肝纤维化流行率高,尤其在人类免疫缺陷病毒(HIV)感染患者中。相比未感染者,HIV感染者充血性心力衰竭风险增加。肝纤维化分期是否与充血性心力衰竭事件相关,是否HIV或者丙型肝炎病毒(HCV)感染会改变此相关性,目前仍不清楚。近期美国学者于著名肝脏病学杂志Hepatology发表文章以评价:(1)肝纤维化分期是否与充血性心力衰竭独立相关;(2)肝纤维化分期与充血性心力衰竭的相关性是否会受HIV/HC

肝纤维化流行率高,尤其在人类免疫缺陷病毒(HIV)感染患者中。相比未感染者,HIV感染者充血性心力衰竭风险增加。肝纤维化分期是否与充血性心力衰竭事件相关,是否HIV或者丙型肝炎病毒(HCV)感染会改变此相关性,目前仍不清楚。

近期美国学者于著名肝脏病学杂志Hepatology发表文章以评价:(1)肝纤维化分期是否与充血性心力衰竭独立相关;(2)肝纤维化分期与充血性心力衰竭的相关性是否会受HIV/HCV影响。

本课题的研究对象为退伍军人队列研究中的健在或2003年4月1号之后的参与者。无心血管疾病的参与者被随访直到他们第一次发生血性心力衰竭、死亡、最后的随访日期或者到2011年12月31号。使用FIB-4(由年龄、转氨酶和血小板计算获得)评估肝纤维化。

Cox比例危险回归模型对心血管疾病风险因素进行调整。超过6.9年的随访研究表明,在96,373位参与者中有3,844例参与者发生充血性心力衰竭。FIB-4在1.45-3.25之间(中度纤维化)和FIB-4>3.25(显着纤维化/硬化)与充血性心力衰竭相关[(HR (95% CI)=1.17 (1.07-1.27); 1.65(1.43-1.92)]。显着纤维化/硬化与充血性心力衰竭相关性不受HIV/HCV影响。

中晚期肝纤维化/肝硬化与充血性心力衰竭风险相关,相关性不受HIV/HCV影响。评估肝脏健康状况对于减少充血性心力衰竭可能很重要,特别是在HIV和HCV患者中,这些患者心血管疾病风险增加,肝脏疾病普遍存在。

原始出处:So-Armah KA,et al. FIB-4 stage of liver fibrosis predicts incident heart failure among HIV infected and uninfectedpatients.Hepatology. 2017 May 24. doi: 10.1002/hep.29285.

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    2017-06-10 gwc384
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    2017-06-10 lsndxfj
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    2017-06-10 lsndxfj
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    2017-06-08 1e0f8808m18(暂无匿称)

    非常好的文章,学习了。

    0

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