肝脏储备功能低下是急性肝衰竭患者发生急性胰腺炎的一个危险因素。

IF 3.9 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology Research Pub Date : 2024-06-14 DOI:10.1111/hepr.14083

Keisuke Kakisaka, Tokio Sasaki, Ippeki Nakaya, Takuya Watanabe, Hiroaki Abe, Kenji Yusa, Yudai Fujiwara, Tamami Abe, Akiko Suzuki, Kei Endo, Yuichi Yoshida, Takayoshi Oikawa, Kei Sawara, Akio Miyasaka, Hidekatsu Kuroda, Takayuki Matsumoto

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引用次数: 0

摘要

目的：急性胰腺炎是急性肝衰竭（ALF）的并发症之一。本研究旨在探讨急性胰腺炎在 ALF 患者中的发病率及相关临床特征：我们回顾性分析了2011-2018年间确诊的无肝性脑病的ALF患者队列，并比较了急性胰腺炎患者和无急性胰腺炎患者的临床特征。急性胰腺炎根据《2021年急性胰腺炎临床实践指南》进行诊断。研究人员进行了多变量分析，以确定与急性胰腺炎相关的因素：83例ALF患者无肝性脑病（34例男性；11例死亡；6例肝移植；中位年龄63岁）。9名患者（10.8%）发生急性胰腺炎。从ALF到急性胰腺炎发生的中位时间为8天。急性胰腺炎患者的存活率低于非急性胰腺炎患者（22% 对 86%）。研究发现，终末期肝病评分模型（危险比为1.10，95%置信区间为1.03-1.18）是与急性胰腺炎相关的重要因素，而甘油三酯、年龄和性别则不是：结论：终末期肝病评分高模型可能是对有急性胰腺炎风险的 ALF 患者进行分层的标志。

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Low liver reserve is a risk factor for acute pancreatitis in patients with acute liver failure.

Aim: Acute pancreatitis is a complication of acute liver failure (ALF). This study aimed to investigate the prevalence of and clinical features associated with acute pancreatitis in patients with ALF.

Methods: We retrospectively analyzed a cohort of ALF patients without hepatic encephalopathy diagnosed during a period 2011-2018, and compared clinical features between patients with acute pancreatitis and those without. Acute pancreatitis was diagnosed according to the Acute Pancreatitis Clinical Practice Guidelines 2021. A multivariate analysis was carried out to identify factors associated with acute pancreatitis.

Results: There were 83 ALF patients without hepatic encephalopathy (34 men; 11 deaths; 6 liver transplants; median age, 63 years). Acute pancreatitis occurred in nine patients (10.8%). The median time duration from ALF to the onset of acute pancreatitis was 8 days. The survival rate was lower in patients with than those without acute pancreatitis (22% vs. 86%). The model for end-stage liver disease score (hazard ratio 1.10, 95% confidence interval 1.03-1.18) was found to be a significant factor associated with acute pancreatitis, whereas triglyceride, age, and sex were not.

Conclusions: A high model for end-stage liver disease score may be a marker to stratify patients with ALF at a risk of acute pancreatitis.

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来源期刊

Hepatology Research 医学-胃肠肝病学

CiteScore

8.30

自引率

14.30%

发文量

124

审稿时长

1 months

期刊介绍： Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.