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肝硬化食管胃静脉曲张再出血相关因素研究进展
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作者 顾达 童聪 +1 位作者 赵祥安 向晓星 《世界华人消化杂志》 CAS 2022年第5期230-234,共5页
肝硬化食管胃静脉曲张再出血是食管胃静脉曲张出血患者二级预防的重点,其能显著增加患者死亡风险,严重影响肝硬化患者的预后.目前临床上不仅关注于影响肝硬化食管胃静脉曲张首次出血及其预后的相关因素,对再出血相关因素分析总结也是关... 肝硬化食管胃静脉曲张再出血是食管胃静脉曲张出血患者二级预防的重点,其能显著增加患者死亡风险,严重影响肝硬化患者的预后.目前临床上不仅关注于影响肝硬化食管胃静脉曲张首次出血及其预后的相关因素,对再出血相关因素分析总结也是关注的重点内容,本文旨在从临床资料出发归纳总结肝硬化食管胃静脉曲张患者流行病学、实验室指标、内镜及影像学、常用评分系统等方面对再出血的影响,从而有助于临床医生制定个体化治疗方案和预防策略,降低再出血率及病死率,改善患者预后. 展开更多
关键词 肝硬化食管胃静脉曲张再出血 门静脉高压 综述
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Gamma-glutamyl Transpeptidase to Platelet Ratio Predicts Liver Injury in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients With Normal Alanine Aminotransferase 被引量:9
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作者 xiang-an zhao Jian Wang +13 位作者 Jie Wei Jiacheng Liu Guangmei Chen Li Wang Guiyang Wang Juan Xia Weihua Wu Shengxia Yin Xin Tong Xiaomin Yan Weimao Ding Xiaoxing Xiang Rui Huang Chao Wu 《Journal of Clinical and Translational Hepatology》 SCIE 2022年第2期247-253,共7页
Background and Aims:Chronic hepatitis B virus(HBV)infection is a serious health problem worldwide.Evaluating liver injury in patients with hepatitis B e antigen(HBeAg)-negative chronic hepatitis B(CHB)with detectable ... Background and Aims:Chronic hepatitis B virus(HBV)infection is a serious health problem worldwide.Evaluating liver injury in patients with hepatitis B e antigen(HBeAg)-negative chronic hepatitis B(CHB)with detectable HBV DNA and normal alanine aminotransferase(ALT)is crucial to guide their clinical management.We aimed to investigate the stages of liver inflammation and fibrosis as well as the predictive accuracy of gamma-glutamyl transpepti-dase-to-platelet ratio(GPR)in these patients.Methods:A total of 184 treatment-naïve HBeAg-negative CHB pa-tients with detectable HBV DNA and normal ALT were enrolled.The Scheuer scoring system was used to classify liver inflammation and fibrosis.Results:The distribution of patients with different liver inflammation grades were as follows:G0,0(0%);G1,97(52.7%);G2,68(37.0%);G3,12(6.5%);and G4,7(3.8%).The distribution of patients with different liver fibrosis stages were as follows:S0,22(12.0%);S1,72(39.1%);S2,42(22.8%);S3,19(10.3%);and S4,29(15.8%).The areas under the re-ceiver operating characteristic(AUROC)curves of GPR in predicting significant inflammation,severe inflammation,and advanced inflammation were 0.723,0.895,and 0.952,respectively.The accuracy of GPR was significantly superior to that of ALT in predicting liver inflammation.The AUROCs of GPR in predicting significant fibrosis,severe fibrosis,and cirrhosis were 0.691,0.780,and 0.803,respectively.The predictive accuracy of GPR was significantly higher than that of aminotransferase-to-platelet ratio index(APRI)and fibrosis index based on four factors(FIB-4)in identifying advanced fibrosis and cirrhosis,and it was superior to FIB-4 but comparable to APRI in identifying significant fibrosis.Conclusions:Nearly half of the HBeAg-negative CHB patients with detectable HBV DNA and normal ALT levels had significant liver inflammation or fibrosis.GPR can serve as an accurate predictor of liver inflammation and fibrosis in these patients. 展开更多
关键词 Chronic hepatitis B Liver injury Gamma-glutamyl transpeptidase PLATELET
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