Am J Gastroenterol:肝结节病的临床特征和结果

2017-09-12 MedSci MedSci原创

总之,大多数肝结节病患者无肝损害症状,ALP和GGT水平升高是最常见的异常生化检测。肝活检显示几乎所有病例均无肉芽肿。肝硬化可在患者中出现。因研究的人群主要是白种人,对其他人群的研究可能有限。在更多样化的人群中,肝结节病的患病率可能更高。

有关肝结节病的临床表现和结果的资料很少。该项研究的主要目的是采用一群以人群为基础的结节病患者队列,更好地描述肝结节病的特征。

从1976年到2013年,在美国明尼苏达州奥姆斯特郡,从数据库中发现了一组结节病病例。经个人医疗记录复查证实患者患有肝结节病。随后对已确诊的结节病病例进行肝介入检查。评估患者临床表现、影像学检测、肝脏生化检测、治疗及结果等资料。评估根据死亡竞争风险调整的肝硬化累积发病率。

研究结果表明,共发现345例肝结节病例。其中,19例(6%)有肝脏损害(平均年龄46.1岁,53%的患者为女性,79%的患者为白种人)。大多数患者无肝脏损害症状。通过肝脏生化、影像学检测发现有异常生化结果和影像学结果时,发现患者患有肝结节病。大多数患者血清碱性磷酸酶(ALP)和谷氨酰转酞酶(GGT)水平升高。升高的转氨酶并不常见,也不严重。大约一半的患者有异常影像学检查结果,低密度结节病变是最常见的异常(6例患者),其次是肝肿大(3例患者)。肝组织活检表明,非肉芽肿占88%(14/16)。4例患者发生肝硬化。

总之,大多数肝结节病患者无肝损害症状,ALP和GGT水平升高是最常见的异常生化检测。肝活检显示几乎所有病例均无肉芽肿。肝硬化可在患者中出现。因研究的人群主要是白种人,对其他人群的研究可能有限。在更多样化的人群中,肝结节病的患病率可能更高。

原始出处:

Ungprasert P, Crowson CS, Simonetto DA, et al. Clinical Characteristics and Outcome of Hepatic Sarcoidosis: A Population-Based Study 1976-2013. Am J Gastroenterol, 2017, Sep 5. doi: 10.1038/ajg.2017.231.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!


版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1842869, encodeId=97761842869d5, content=<a href='/topic/show?id=112222886b8' target=_blank style='color:#2F92EE;'>#临床特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22886, encryptionId=112222886b8, topicName=临床特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Apr 10 01:17:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064197, encodeId=04a9206419e74, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri May 18 13:17:00 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984238, encodeId=115619842380f, content=<a href='/topic/show?id=6771813e472' target=_blank style='color:#2F92EE;'>#肝结节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81374, encryptionId=6771813e472, topicName=肝结节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Thu Aug 23 17:17:00 CST 2018, time=2018-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711193, encodeId=82c31e11193da, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Jul 23 09:17:00 CST 2018, time=2018-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071904, encodeId=ae9420e1904c7, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, 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=Thu Sep 21 06:17:00 CST 2017, time=2017-09-21, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1842869, encodeId=97761842869d5, content=<a href='/topic/show?id=112222886b8' target=_blank style='color:#2F92EE;'>#临床特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22886, encryptionId=112222886b8, topicName=临床特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Apr 10 01:17:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064197, encodeId=04a9206419e74, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri May 18 13:17:00 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984238, encodeId=115619842380f, content=<a href='/topic/show?id=6771813e472' target=_blank style='color:#2F92EE;'>#肝结节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81374, encryptionId=6771813e472, topicName=肝结节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Thu Aug 23 17:17:00 CST 2018, time=2018-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711193, encodeId=82c31e11193da, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Jul 23 09:17:00 CST 2018, time=2018-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071904, encodeId=ae9420e1904c7, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, 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=Thu Sep 21 06:17:00 CST 2017, time=2017-09-21, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1842869, encodeId=97761842869d5, content=<a href='/topic/show?id=112222886b8' target=_blank style='color:#2F92EE;'>#临床特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22886, encryptionId=112222886b8, topicName=临床特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Apr 10 01:17:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064197, encodeId=04a9206419e74, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri May 18 13:17:00 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984238, encodeId=115619842380f, content=<a href='/topic/show?id=6771813e472' target=_blank style='color:#2F92EE;'>#肝结节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81374, encryptionId=6771813e472, topicName=肝结节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Thu Aug 23 17:17:00 CST 2018, time=2018-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711193, encodeId=82c31e11193da, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Jul 23 09:17:00 CST 2018, time=2018-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071904, encodeId=ae9420e1904c7, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, 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=Thu Sep 21 06:17:00 CST 2017, time=2017-09-21, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1842869, encodeId=97761842869d5, content=<a href='/topic/show?id=112222886b8' target=_blank style='color:#2F92EE;'>#临床特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22886, encryptionId=112222886b8, topicName=临床特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Apr 10 01:17:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064197, encodeId=04a9206419e74, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri May 18 13:17:00 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984238, encodeId=115619842380f, content=<a href='/topic/show?id=6771813e472' target=_blank style='color:#2F92EE;'>#肝结节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81374, encryptionId=6771813e472, topicName=肝结节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Thu Aug 23 17:17:00 CST 2018, time=2018-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711193, encodeId=82c31e11193da, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Jul 23 09:17:00 CST 2018, time=2018-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071904, encodeId=ae9420e1904c7, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, 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=Thu Sep 21 06:17:00 CST 2017, time=2017-09-21, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1842869, encodeId=97761842869d5, content=<a href='/topic/show?id=112222886b8' target=_blank style='color:#2F92EE;'>#临床特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22886, encryptionId=112222886b8, topicName=临床特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Apr 10 01:17:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064197, encodeId=04a9206419e74, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri May 18 13:17:00 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984238, encodeId=115619842380f, content=<a href='/topic/show?id=6771813e472' target=_blank style='color:#2F92EE;'>#肝结节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81374, encryptionId=6771813e472, topicName=肝结节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bcd469, createdName=fengting3, createdTime=Thu Aug 23 17:17:00 CST 2018, time=2018-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711193, encodeId=82c31e11193da, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Jul 23 09:17:00 CST 2018, time=2018-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071904, encodeId=ae9420e1904c7, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, 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=Thu Sep 21 06:17:00 CST 2017, time=2017-09-21, status=1, ipAttribution=)]
    2017-09-21 许安