BACKGROUND Current research has identified several risk factors for refractory benign esophageal strictures (RBES), but research is scarce on the prediction of RBES in benign esophageal strictures patients. Meanwhile,...BACKGROUND Current research has identified several risk factors for refractory benign esophageal strictures (RBES), but research is scarce on the prediction of RBES in benign esophageal strictures patients. Meanwhile, the long-term outcomes of RBES remain unclear. The aim of this study was to develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures. And we also explored the long-term outcomes and safety in patients with RBES. AIM To develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures, based on the demographic data and endoscopic findings. METHODS A total of 507 benign esophageal stricture patients treated by dilation alone or in combination with stenting were retrospectively enrolled between January 2009 and February 2018. The primary outcome was to establish a risk-scoring model predicting RBES in benign esophageal strictures. The secondary outcome was to explore the clinical effectiveness and adverse events in patients with RBES. RESULTS In the study, age, etiology, and number and length of strictures were the independent risk factors for the refractory performance of benign esophageal strictures. According to risk factors of benign esophageal strictures, a risk-scoring model for predicting RBES in benign esophageal strictures was established: The risk score ranged from 0 to 8 points, and the risk scores were divided into low risk (0-2 points), intermediate risk (3-5 points), and high risk (6-8 points). The proportions of RBES in the corresponding risk categories were 1.0%, 12.2%, and 76.0%, respectively. Among 507 patients, 57 had RBES (39 males;median age, 60 years). The success rate of dilation treatment (51.2%, 21/41) was higher than that of stent placement (37.5%, 6/16). CONCLUSION In this study, 11.3%(57/507) patients had RBES at our hospital. The risk-scoring model predicting RBES in benign esophageal strictures could predict the longterm outcome of patients with strictures ahead.展开更多
To the Editor:Nonalcoholic fatty liver disease(NAFLD)is a growing public health problem globally.Although the primary liver pathology in NAFLD patients is associated with an increased risk of overall mortality,the maj...To the Editor:Nonalcoholic fatty liver disease(NAFLD)is a growing public health problem globally.Although the primary liver pathology in NAFLD patients is associated with an increased risk of overall mortality,the majority of deaths in NAFLD patients are due to the cardiovascular disease(CVD)[1].With the change of lifestyle,the prevalence of NAFLD in China is increasing and patients tend to be younger[2].A relevant epidemiological survey has shown that the prevalence of NAFLD in adults is estimated to be 12%–24%in Asia[3].Non-high-density lipoprotein cholesterol(non-HDL-C)refers to the sum of all cholesterol subtracts high-density lipoprotein cholesterol(HDL-C),which can more comprehensively reflect the comprehensive metabolic changes of lipoproteins including low-density lipoprotein cholesterol(LDL-C),intermediate-density lipoprotein cholesterol(IDL-C),and very-low-density lipoprotein cholesterol(VLDL-C)[4].Recently,NAFLD that often coexists with dyslipidemia has been identified as a major modifiable risk factor of CVD,and non-HDL-C has become a new biomarker for assessing and predicting the risk of CVD[4].展开更多
文摘BACKGROUND Current research has identified several risk factors for refractory benign esophageal strictures (RBES), but research is scarce on the prediction of RBES in benign esophageal strictures patients. Meanwhile, the long-term outcomes of RBES remain unclear. The aim of this study was to develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures. And we also explored the long-term outcomes and safety in patients with RBES. AIM To develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures, based on the demographic data and endoscopic findings. METHODS A total of 507 benign esophageal stricture patients treated by dilation alone or in combination with stenting were retrospectively enrolled between January 2009 and February 2018. The primary outcome was to establish a risk-scoring model predicting RBES in benign esophageal strictures. The secondary outcome was to explore the clinical effectiveness and adverse events in patients with RBES. RESULTS In the study, age, etiology, and number and length of strictures were the independent risk factors for the refractory performance of benign esophageal strictures. According to risk factors of benign esophageal strictures, a risk-scoring model for predicting RBES in benign esophageal strictures was established: The risk score ranged from 0 to 8 points, and the risk scores were divided into low risk (0-2 points), intermediate risk (3-5 points), and high risk (6-8 points). The proportions of RBES in the corresponding risk categories were 1.0%, 12.2%, and 76.0%, respectively. Among 507 patients, 57 had RBES (39 males;median age, 60 years). The success rate of dilation treatment (51.2%, 21/41) was higher than that of stent placement (37.5%, 6/16). CONCLUSION In this study, 11.3%(57/507) patients had RBES at our hospital. The risk-scoring model predicting RBES in benign esophageal strictures could predict the longterm outcome of patients with strictures ahead.
基金a grant from Zhejiang Natural Science Foundation(LY20H2000025).the Ethics Committee of the FirstAffiliated Hospital of Zhejiang University School of Medicine (No.2019-1486).
文摘To the Editor:Nonalcoholic fatty liver disease(NAFLD)is a growing public health problem globally.Although the primary liver pathology in NAFLD patients is associated with an increased risk of overall mortality,the majority of deaths in NAFLD patients are due to the cardiovascular disease(CVD)[1].With the change of lifestyle,the prevalence of NAFLD in China is increasing and patients tend to be younger[2].A relevant epidemiological survey has shown that the prevalence of NAFLD in adults is estimated to be 12%–24%in Asia[3].Non-high-density lipoprotein cholesterol(non-HDL-C)refers to the sum of all cholesterol subtracts high-density lipoprotein cholesterol(HDL-C),which can more comprehensively reflect the comprehensive metabolic changes of lipoproteins including low-density lipoprotein cholesterol(LDL-C),intermediate-density lipoprotein cholesterol(IDL-C),and very-low-density lipoprotein cholesterol(VLDL-C)[4].Recently,NAFLD that often coexists with dyslipidemia has been identified as a major modifiable risk factor of CVD,and non-HDL-C has become a new biomarker for assessing and predicting the risk of CVD[4].