酒精性肝硬化和病毒性肝硬化患者食管静脉曲张内镜治疗后的疗效和复发率

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Yoshihiro Furuichi, Ryohei Nishiguchi, Takeshi Shimakawa, Tomoyuki Fujiwara, Koichiro Sato, Hiroyuki Kato
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引用次数: 0

摘要

背景:酒精性肝硬化(ALC)的发病率正在上升。然而,很少有报道关注 ALC 衍生的食管静脉曲张(EV)。我们回顾性研究了ALC和肝性B/C病毒性肝硬化(B/C-LC)患者接受内镜注射硬化剂治疗(EIS)后总生存期(OS)和EV复发率的差异:我们分析了215例接受EIS治疗的患者(B/C-LC,147例;ALC,68例)的数据。主要终点是未成功戒断的 ALC 患者和未控制的 B/C-LC 患者在统一患者背景的倾向评分匹配(PSM)前后的 OS 和 EV 复发率。次要终点是通过多变量分析确定的与这些因素相关的预测因子:观察期为 1,430 ± 1,363 天。在对所有患者的分析中,ALC组的OS明显高于B/C-LC组(P = 0.039);但EV复发率没有差异(P = 0.502)。腹水和肝细胞癌(HCC)病史(p = 0.019 和 p < 0.001)预测 OS,而年龄和 EV 大小预测复发(p = 0.011 和 0.024)。共有96名无HCC病史的患者通过PSM进行了配对,OS和EV复发率没有显著差异(分别为p = 0.508和0.246):结论:如果仅限于无 HCC 病史的患者,继续饮酒的 ALC 患者与未控制病毒的 B/C-LC 患者的 OS 和 EV 复发率相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes and Recurrence Rate of Esophageal Varices after Endoscopic Treatment in Patients with Alcoholic Cirrhosis and Viral Cirrhosis.

Background: The incidence of alcoholic liver cirrhosis (ALC) is increasing. However, few reports have focused on ALC-derived esophageal varices (EV). We retrospectively examined differences in overall survival (OS) and EV recurrence rate in patients after endoscopic injection sclerotherapy (EIS) for ALC and hepatic B/C virus liver cirrhosis (B/C-LC).

Methods: We analyzed data from 215 patients (B/C-LC, 147; ALC, 68) who underwent EIS. The primary endpoints were OS and EV recurrence in patients with unsuccessful abstinence ALC and those with uncontrolled B/C-LC, before and after propensity score matching (PSM) to unify the patients' background. The secondary endpoints were predictors associated with these factors, as determined by multivariate analysis.

Results: The observation period was 1,430 ± 1,363 days. In the analysis of all patients, OS was significantly higher in the ALC group than in the B/C-LC group (p = 0.039); however, there was no difference in EV recurrence rate (p = 0.502). Ascites and history of hepatocellular carcinoma (HCC) (p = 0.019 and p < 0.001, respectively) predicted OS, whereas age and EV size predicted recurrence (p = 0.011 and 0.024, respectively). In total, 96 patients without an HCC history were matched by PSM, and there was no significant difference in OS or EV recurrence rate (p = 0.508 and 0.246, respectively).

Conclusion: When limited to patients without a history of HCC, OS and the EV recurrence rate were comparable in patients with ALC who continued to consume alcohol and those with B/C-LC without viral control.

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来源期刊
Journal of Nippon Medical School
Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-
CiteScore
1.80
自引率
10.00%
发文量
118
期刊介绍: The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.
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