肝硬化的自然历史：多年来的流行病学变化趋势

StephenW

NATURAL HISTORY OF CIRRHOSIS: CHANGING TRENDS IN ETIOLOGY OVER THE YEARS
Ramazan Idilman, Merve Aydogan, Mehmet Berk Oruncu, Aysun Kartal, Atilla Halil Elhan, Zeynep Ellik, Mesut Gumussoy, Ramazan Erdem Er, Mubin Ozercan, Serkan Duman, Murat Toruner, Kubilay Cinar, Irfan Soykan, Ali Resit Beyler, Hasan Ozkan

    PMID: 33142287 DOI: 10.1159/000512746

Abstract

Background and goals: The aims of the present study were to investigate the natural history of cirrhosis and to determine trends in the etiology of cirrhosis.

Methods: Between January 2001 and January 2018, a total of 1341 patients had been diagnosed with cirrhosis were included.

Results: A total of 898 cirrhotic patients, who were followed for at least six months were included into the analysis. The median age was 54 years. The median Child-Pugh and MELD scores were 7.5 and 11, respectively. Ascites (51%) was the most common causes of decompensation. Chronic viral hepatitis was the most frequent cause of cirrhosis (58%). Hepatitis B virus (HBV) infection was the main etiology (34%), followed by hepatitis C virus (HCV) infection (18%). Among 129 patients with cryptogenic cirrhosis (CC), 60 had metabolic abnormalities. If these 60 patients with CC were considered to have non-alcoholic fatty liver disease (NAFLD)-related cirrhosis, the proportion of NAFLD-related cirrhosis increased from 1.8% to 8.0%. At admission, 74 patients (8%) had been diagnosed with hepatocellular carcinoma (HCC). A new HCC developed in 80 patients during the follow-up period. The probability of developing HCC was 3.9% at 12 months. Logistic regression analysis showed that the development of HCC was significantly associated with older age (p<0.001), male gender (p<0.001), viral etiology (p=0.026) and baseline high aspartate aminotransferase level (p=0.01). Overall, 104 cirrhotic patients died.

In conclusion: HBV and HCV remain the leading causes of etiology in cirrhosis and HCC. However, NAFLD-related cirrhosis is recognized is recognized as a growing burden.

© 2020 S. Karger AG, Basel.

StephenW

肝硬化的自然历史：多年来的流行病学变化趋势
Ramazan Idilman，Merve Aydogan，Mehmet Berk Oruncu，Aysun Kartal，Atilla Halil Elhan，Zeynep Ellik，Mesut Gumussoy，Ramazan Erdem Er，Mubin Ozercan，Serkan Duman，Murat Toruner，Kubilay Cinar，Irfan Soykan，Ali Resit Beyler，哈桑

    PMID：33142287 DOI：10.1159 / 000512746

抽象

背景和目的：本研究的目的是调查肝硬化的自然病史并确定肝硬化病因的趋势。

方法：2001年1月至2018年1月，共纳入1341例被诊断为肝硬化的患者。

结果：总共898名肝硬化患者接受了至少六个月的随访分析。中位年龄是54岁。 Child-Pugh和MELD的中位数分别为7.5和11。腹水（51％）是失代偿的最常见原因。慢性病毒性肝炎是肝硬化的最常见原因（58％）。主要病因是乙型肝炎病毒（HBV）感染（34％），其次是丙型肝炎病毒（HCV）感染（18％）。在129例隐源性肝硬化（CC）患者中，有60例患有代谢异常。如果将这60例CC患者视为非酒精性脂肪肝相关性肝硬化，则NAFLD相关性肝硬化的比例从1.8％增加到8.0％。入院时，已确诊74例（8％）肝细胞癌（HCC）。在随访期间，新的HCC在80名患者中发生。在12个月时发生HCC的可能性为3.9％。 Logistic回归分析表明，HCC的发生与年龄（p <0.001），男性（p <0.001），病毒病因（p = 0.026）和基线高天冬氨酸转氨酶水平（p = 0.01）显着相关。总体而言，有104位肝硬化患者死亡。

结论：HBV和HCV仍然是肝硬化和HCC病因的主要原因。然而，公认的与NAFLD相关的肝硬化是日益增加的负担。

©2020 S.Karger AG，巴塞尔。