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发表于 2002-4-28 23:22
Survival and Prognostic Indicators in Patients with Hepatitis B Virus-Related Cirrhosis After Onset of Hepatic Decompensation
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Date: Thu, 25 Apr 2002 06:00:37 -0400
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Survival and Prognostic Indicators in Patients with Hepatitis B
Virus-Related Cirrhosis After Onset of Hepatic Decompensation
Alex Yui Hui, M.D.; Henry Lik-yuen Chan, M.D.; Nancy Wai-yee Leung, M.D.;
Lawrence Cheung-tsui Hung, M.D.; Francis Ka-leung Chan, M.D.; Joseph Jao-yiu
Sung, M.D., Ph.D.
From the Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong (A.Y.H., H.L.C., N.W.L., L.C.H., F.K.C., J.J.S.); and the Division of Liver Diseases, Mount Sinai School of Medicine, New York, New York (A.Y.H.), U.S.A.
JOURNAL OF CLINICAL GASTROENTEROLOGY 2002;34:569-572
Abstract
Goals: To determine the 2-year survival and prognostic indicators of
hepatitis B virus-related cirrhosis after the onset of hepatic
decompensation.
Background: Chronic hepatitis B (CHB) patients with cirrhosis and resultant hepatic decompensation have reduced survival. However, the natural history of these patients has not been well characterized in previous studies.
Better understanding of survival and prognostic indicators is essential in management of these patients, especially in determining who should be candidates for orthotopic liver transplantation.
Study: This is a retrospective longitudinal study of 96 patients with
CHB-related cirrhosis after the onset of hepatic decompensation. The overall survival was ascertained, and clinical and laboratory variables were analyzed. Significant prognostic indicators for survival at 2 years were determined using univariate and multivariate analyses with Cox regression model.
Results: The overall survival was 80% at 2 years after onset of
decompensation. With univariate and multivariate analyses, hepatic
encephalopathy and hypoalbuminemia less than 2.8 g/dL were significant prognostic indicators of poor survival probability. The hazard ratios were 5.22 (95% confidence interval, 1.67-16.3) and 8.57 (95% confidence interval, 1.94-37.8), respectively. Patients with hypoalbuminemia less than 2.8 g/dL had a 2-year survival of only 62%.
Conclusions: Our study showed that of CHB patients who developed the first episode of hepatic decompensation, those with hepatic encephalopathy or significant hypoalbuminemia or both have worse prognoses. They should be considered potential candidates for liver transplantation.
J Clin Gastroenterol 2002 May/June;34(5):569-572
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