免疫抑制方案对肝移植后代谢功能障碍相关脂肪肝的影响

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY
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引用次数: 0

摘要

背景代谢功能障碍相关性脂肪肝与肝移植术后终末期肝病患者的不良预后有关。方法 使用终末期肝病患者的术前和术后数据进行了回顾性分析。研究比较了三个不同的组别:以他克莫司为基础的组别、以西罗莫司为基础的组别以及以他克莫司和西罗莫司为基础的联合方案。结果 共有171名患者参与了研究,其中男性127人,女性44人,平均年龄49.6岁。移植后代谢功能障碍相关性脂肪肝的发病率为29.23%。三组肝移植受者中,他克莫司组有111人,西罗莫司组有28人,联合用药组有32人。在代谢功能障碍相关性脂肪肝的发生率方面,三组间差异有统计学意义(P <0.05),而其他术前和术后参数则无明显差异。多变量分析显示,低热量饮食(95% 置信区间:0.15-0.90,P = 0.021)和基于他克莫司和西罗莫司的联合免疫抑制方案(95% 置信区间:1.01-2.77,P = 0.046)与较低的移植后代谢功能障碍相关性脂肪肝风险相关。结论我们的研究表明,实施低热量饮食并采用他克莫司和西罗莫司联合免疫抑制方案可有效降低肝移植后代谢功能障碍相关性脂肪肝的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Immunosuppressive Regimens on Metabolic Dysfunction-associated Fatty Liver Disease Following Liver Transplantation

Background

Metabolic dysfunction-associated fatty liver disease has been linked to negative outcomes in patients with end-stage liver disease following liver transplantation. However, the influence of immunosuppressive regimens on it has not been explored.

Methods

A retrospective analysis was conducted using the preoperative and postoperative data from patients with end-stage liver disease. The study compared three different groups: tacrolimus-based group, sirolimus-based group, and combined tacrolimus- and sirolimus-based regimens. Binary logistic regression analysis was employed to identify risk factors for metabolic dysfunction-associated fatty liver disease.

Results

A total of 171 patients participated in the study, consisting of 127 males and 44 females, with a mean age of 49.6 years. The prevalence of posttransplant metabolic dysfunction-associated fatty liver disease was 29.23%. Among the three groups, there were 111 liver transplant recipients in the tacrolimus-based group, 28 in the sirolimus-based group, and 32 in the combination group. A statistically significant difference was observed in the incidence of metabolic dysfunction-associated fatty liver disease (P < 0.05), whereas the other preoperative and postoperative parameters showed no significant differences. Multivariate analysis revealed that a low-calorie diet (95% confidence intervals: 0.15–0.90, P = 0.021) and a combination of tacrolimus- and sirolimus-based immunosuppressive regimen (95% confidence intervals: 1.01–2.77, P = 0.046) were associated with lower risk of posttransplant metabolic dysfunction-associated fatty liver disease.

Conclusions

Our study indicates that implementing a low-calorie diet and utilizing a combination of tacrolimus- and sirolimus-based immunosuppressive regimen can effectively lower the risk of posttransplant metabolic dysfunction-associated fatty liver disease following liver transplantation.

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来源期刊
Journal of Clinical and Experimental Hepatology
Journal of Clinical and Experimental Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.90
自引率
16.70%
发文量
537
审稿时长
64 days
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