慢性乙型肝炎患者血清丙氨酸氨基转移酶水平和肝脏相关死

StephenW

Liver Int. 2018 Jan 27. doi: 10.1111/liv.13705. [Epub ahead of print]
Serum Alanine Aminotransferase Level and Liver-related Mortality in Patients with Chronic Hepatitis B: A Large National Cohort Study.Shim JJ1, Kim JW1, Oh CH1, Lee YR2, Lee JS3, Park SY4, Kim BH1, Oh IH2.
Author information
1Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea.2Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea.3Clinical Research Center, Asan Medical Center, Seoul, Republic of Korea.4Department of Medical Education and Humanities, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

AbstractBACKGROUND: The serum alanine aminotransferase (ALT) level has been used to identify at-risk patients with chronic hepatitis B (CHB) who need antiviral therapy. However, the level associated with increased liver-related mortality requiring active treatment is still unclear.
METHODS: We used a Health Examination Cohort of the National Health Insurance Service of Korea that included approximately 0.5 million individuals aged 40-79 years. In total, 12,486 patients with CHB and no other concurrent liver disease were enrolled, and patients' liver-related mortality, including that due to liver cancer, was investigated over 9 years.
RESULTS: The serum ALT level was correlated positively with liver-related mortality. The rates in men were 0.14, 0.17, 0.24, 0.57, 0.63, and 0.85 per 100 person-years (%) for serum ALT levels of <20, 20-29, 30-39, 40-49, 50-79, and ≥80 U/L, respectively, and the corresponding liver-related mortality rates in women were 0.03%, 0.09%, 0.12%, 0.63%, 0.65%, and 0.32%. In patients with ALT levels of 40-79 U/L, the liver-related mortality rates were 0.60% in men and 0.64% in women, which were similar to the overall mortality rate of age- and sex-matched subjects without CHB (0.69%). The best cut-off values for liver-related mortality prediction were >34 U/L in men and >30 U/L in women.
CONCLUSIONS: The liver-related mortality rate increased significantly, even in CHB patients with relatively low serum ALT levels. Careful monitoring or earlier antiviral therapy should be considered for patients aged >40 years with serum ALT levels above the upper limit of normal. This article is protected by copyright. All rights reserved.


This article is protected by copyright. All rights reserved.



KEYWORDS: Alanine transaminase; Chronic hepatitis B; Hepatocellular carcinoma; Mortality

PMID:29377574DOI:10.1111/liv.13705

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StephenW

肝脏Int。 2018年1月27日doi：10.1111 / liv.13705。 [电子版提前打印]
慢性乙型肝炎患者血清丙氨酸氨基转移酶水平和肝脏相关死亡率的一项大型国家队列研究。
Shim JJ1，Kim JW1，Oh CH1，Lee YR2，Lee JS3，Park SY4，Kim BH1，Oh IH2。
作者信息

1
韩国首尔庆熙大学医学院内科。
2
韩国首尔庆熙大学医学院预防医学系。
3
临床研究中心，韩国汉城牙山医疗中心。
4
韩国首尔庆熙大学医学院医学教育与人文科学系。

抽象
背景：

然而，与需要积极治疗的肝脏相关死亡率增加有关的水平仍不清楚。
方法：

我们使用了韩国国民健康保险服务的健康检查组，包括大约50万40-79岁的人。总共有12,486例慢性乙型肝炎患者，没有其他并发肝脏疾病的患者入组，9年内调查了肝癌相关死亡率，包括肝癌死亡率。
结果：

血清ALT水平与肝脏相关死亡率呈正相关。血清ALT水平<20,30-39,40-49,50-79和> 80U / ml的男性比例分别为0.14,0.17,0.24,0.57,0.63和0.85 / 100人年（％ L，女性相应的肝脏相关死亡率分别为0.03％，0.09％，0.12％，0.63％，0.65％和0.32％。在ALT水平为40-79 U / L的患者中，男性肝脏相关死亡率为0.60％，女性为0.64％，与没有CHB的年龄和性别相匹配的受试者总体死亡率相似（0.69 ％）。肝脏相关死亡率预测的最佳临界值在男性> 34U / L，女性> 30U / L。
结论：

即使在血清ALT水平相对较低的CHB患者中，肝脏相关死亡率也显着增加。对于血清ALT水平高于正常上限的年龄> 40岁的患者，应考虑谨慎监测或早期抗病毒治疗。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

丙氨酸转氨酶慢性乙型肝炎;肝细胞癌;死亡

结论：
29377574
DOI：
10.1111 / liv.13705

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