ACLF确实存在于HBV相关的失代偿期肝硬化患者中

StephenW

J Dig Dis. 2018 Sep 17. doi: 10.1111/1751-2980.12671. [Epub ahead of print]
ACLF does exist in HBV-related decompensated cirrhotic patients.
Wang SJ1, Yin S1, Gu WY1, Zhang Y1, Li H1.
Author information

1
    Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China.

Abstract
OBJECTIVE:

Acute-on-chronic liver failure (ACLF) may develop from compensated cirrhotic patients with acute decompensation (AD) which was demonstrated in both alcoholic and HBV-related cohorts. However, there is a type of ACLF developing from decompensated cirrhotic patients with AD in alcoholic cirrhosis, which is not certain in Asia-HBV high epidemic area. This research focused to verify whether ACLF can develop from patients with previous decompensation in an HBV-related cohort and identified the homogeneity between these hypothetical ACLF patients and the ACLF that developed from compensated cirrhosis.
METHODS:

Patients with HBV-related cirrhosis and AD were screened and 890 cases were enrolled. 400 cases were with first AD and 157 cases in them were diagnosed with ACLF within 28-days after admission according to EASL-CLIF criteria. Other 490 cases had previous decompensation history and 143 cases in them met the ACLF criteria. The 28-day mortalities, characteristics and important laboratory data changes during hospitalization such as total bilirubin, creatinine, white blood cell counts and MELD score were compared between ACLF patients and the 143 hypothetical ACLF patients.
RESULTS:

The 28-day mortality of 143 hypothetical ACLF patients with previous decompensation had no significant difference with ACLF patients with first AD. The WBC, serum bilirubin, serum creatinine, INR and MELD score exhibited similar variation tendencies in two groups at day1, day7 and day28/discharge/death. And these data in the two groups showed significant difference with the non-ACLF patients.
CONCLUSION:

HBV-related cirrhotic patients with previous decompensation who were diagnosed with ACLF were homogeneous with ACLF developing from compensated cirrhosis. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

acute decompensation; acute-on-chronic liver failure; hepatitis B virus; liver cirrhosis

PMID:
    30226019
DOI:
    10.1111/1751-2980.12671

StephenW

J Dig Dis。 2018年9月17日doi：10.1111 / 1751-2980.12671。 [提前打印]
ACLF确实存在于HBV相关的失代偿期肝硬化患者中。
Wang SJ1，Yin S1，Gu WY1，Zhang Y1，Li H1。
作者信息

1
    上海交通大学医学院附属仁济医院卫生部消化内科，肝病学重点实验室，上海消化病研究所，上海市消化内科

抽象
目的：

急性失代偿（AD）的代偿性肝硬化患者可能发生急性慢性肝功能衰竭（ACLF），这在酒精和HBV相关队列中得到证实。然而，在酒精性肝硬化的失代偿期肝硬化患者中发生了一种类型的ACLF，这在亚洲 - HBV高流行区尚不确定。该研究的重点是验证ACLF是否可以从HBV相关队列中先前失代偿的患者中发展，并确定这些假设的ACLF患者与由代偿性肝硬化产生的ACLF之间的同质性。
方法：

对HBV相关性肝硬化和AD患者进行筛查，共纳入890例患者。首次AD患者400例，其中157例根据EASL-CLIF标准在入院后28天内被诊断为ACLF。其他490例患者有先前的失代偿史，其中143例符合ACLF标准。比较ACLF患者和143名假设的ACLF患者在住院期间的28天死亡率，特征和重要的实验室数据变化，如总胆红素，肌酐，白细胞计数和MELD评分。
结果：

先前失代偿的143例假设ACLF患者的28天死亡率与首次AD的ACLF患者无显着差异。在第1天，第7天和第28天/出院/死亡时，WBC，血清胆红素，血清肌酐，INR和MELD评分在两组中表现出相似的变异趋势。并且这两组数据显示与非ACLF患者有显着差异。
结论：

既往失代偿的HBV相关肝硬化患者被诊断为ACLF，其均为伴有代偿性肝硬化的ACLF。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：

急性失代偿;急性慢性肝功能衰竭;乙型肝炎病毒;肝硬化

结论：
    30226019
DOI：
    10.1111 / 1751-2980.12671