Am J Gastroenterol:2004-13年肝硬化患者1年及30天死亡风险变化趋势

2017-06-14 zhangfan MedSci原创

研究表明,对于肝硬化患者,住院死亡率的减少并未导致1年死亡率和30天死亡率的显著变化。该现象表明肝硬化患者的死亡风险目前已经由住院期间转移至出院期间

最近的数据显示肝硬化患者住院死亡率呈下降趋势,研究人员就肝硬化患者短期疗效改善与长期预后的变化之间的关系开展研究。研究人员对2004-13年间,126所退伍军人管理局医院肝硬化住院患者的30天以及1年患者死亡率进行了研究,对结果通过人口统计学、肝病严重度和合并症等相关因素进行调整。研究发现在研究期间共109358名肝硬化住院患者,住院死亡率从11.4%下降至7.6%,1年死亡率由34.5%下降至33.2%。有超过1/3的出院患者在30天内死亡,30天死亡率由9.3%上升至10.1%。对病人因素进行调整后,相比于2004年,2013年的住院患者死亡比值比下降30%(OR=0.70,95% CI=0.64–0.78),1年死亡率比值比下降13%(OR=0.87,95% CI=0.82–0.93),30天死亡率比值比上升10%(OR=1.10,95% CI=0.99–1.21)研究表明,对于肝硬化患者,住院死亡率的减少并未导致1年死亡率和30天死亡率的显著变化。该现象表明肝硬化患者的死亡风险目前已经由住院期间转移至出院期间。原始出处:Fasiha Kanwal et al. Trends i

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    2018-01-26 许安
  3. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Jun 14 13:46:39 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210602, encodeId=fa5221060286, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 14 09:42:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210593, encodeId=0f552105936a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Jun 14 09:40:49 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210587, encodeId=a90c21058ede, content=学习了。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Wed Jun 14 09:36:14 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210581, encodeId=f7e62105810c, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Jun 14 09:26:06 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-09-09 smlt2008
  5. 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  6. 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objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Jun 14 09:40:49 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210587, encodeId=a90c21058ede, content=学习了。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Wed Jun 14 09:36:14 CST 2017, time=2017-06-14, status=1, ipAttribution=), 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    2017-06-14 虈亣靌

    好好学习,感谢分享

    0

  7. 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objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Jun 14 09:40:49 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210587, encodeId=a90c21058ede, content=学习了。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Wed Jun 14 09:36:14 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210581, encodeId=f7e62105810c, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Jun 14 09:26:06 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 明月清辉

    谢谢分享,学习了

    0

  8. 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objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Jun 14 09:40:49 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210587, encodeId=a90c21058ede, content=学习了。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Wed Jun 14 09:36:14 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210581, encodeId=f7e62105810c, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Jun 14 09:26:06 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 龙胆草

    学习谢谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2064122, encodeId=100f206412235, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Wed Apr 11 17:52:00 CST 2018, time=2018-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071796, encodeId=398320e1796b1, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, 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objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Jun 14 09:40:49 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210587, encodeId=a90c21058ede, content=学习了。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Wed Jun 14 09:36:14 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210581, encodeId=f7e62105810c, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Jun 14 09:26:06 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 我是谁??

    学习了。。。。。

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=210581, encodeId=f7e62105810c, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Jun 14 09:26:06 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 Y—xianghai

    学习了新知识

    0

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2017年5月,发表在《JAMA Intern Med》的一项由意大利科学家进行的荟萃分析表明,噻唑烷二酮类疗法可改善非酒精性脂肪肝(NASH)患者晚期肝纤维化。

Gut:肝硬化真菌菌群失调!

由此可见,在肝硬化患者中存在显著的真菌失调,其可被被抗生素和使用质子泵抑制剂所改变,但随着时间推移趋于稳定。合并的细菌-真菌菌群失调的指标,拟杆菌/子囊率,可以独立预测肝硬化患者90天的住院治疗情况。

人白蛋白对治疗失代偿肝硬化的影响

  今天提出的ANSWER研究结果显示,长期服用人白蛋白可提高失代偿期肝硬化(慢性肝病的症状期)患者的生存率。 2017年在荷兰阿姆斯特丹举行的国际肝脏大会上的研究表明,用人白蛋白治疗也改善了腹水的治疗(腹腔积液)和生活质量,降低了严重并发症的发生率和住院的需要。 在肝脏长时间损伤以及器官的循环和功能受损(门静脉高压和肝功能不全)后,肝细胞严重纤维化沉积(瘢痕形成)和肝细胞数量

Obstet Gynecol:肝硬化孕妇的临床和产科并发症!

与早期研究相比,尽管孕妇和胎儿死亡率较低,但肝硬化妇女的妊娠仍然与产科不良结局的高风险相关。

DDW:改善肝硬化疾病的基因标记物

丙型肝炎病毒的晚期肝硬化患者的基因分型可以帮助卫生保健专业人员预测丙型肝炎治疗成功后的可能性,从而最大限度地减少对肝脏移植的需求。这项研究是在2017年消化疾病周(DDW)上提出来的,DDW是消除胃肠病学,肝病学,内窥镜检查和胃肠手术领域最大的国际医师,研究人员和学术界的国际聚会。

Clin Gastroenterol H:慢性肝病患者服用他汀类药物与肝硬化及相关并发症的风险分析!

基于系统评价和荟萃分析结果,他汀类药物的使用可能与肝功能失代偿和死亡风险降低相关,并可能会降低CLD患者的门脉高压。需要前瞻性观察性研究和随机对照试验来进一步证实这种观察。