肝移植对结肠炎溃疡性合并原发性硬化性胆管炎患者肠道及全身炎症指标的影响

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

Przegla̜d Gastroenterologiczny Pub Date : 2024-01-01 Epub Date: 2024-12-04 DOI:10.5114/pg.2024.145575

Artur W Uździcki, Marta Wawrzynowicz-Syczewska

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引用次数: 0

摘要

原发性硬化性胆管炎（PSC）是一种罕见的慢性肝病，以胆管纤维化和狭窄为特征，引起胆汁淤积。从长远来看，它会导致完全狭窄，进而导致肝硬化。对于病情严重的患者，推荐的治疗方法是肝移植。由于PSC经常与溃疡性结肠炎（UC）共存，因此确定肝移植对UC病程的影响至关重要。目的：目的是确定肝移植对UC合并PSC （PSC-UC）的肠道和全身炎症标志物的影响。材料和方法：纳入63例PSC- uc患者，其中25例因PSC进展而接受肝移植（OLTx）。观察临床症状、粪便钙保护蛋白水平、血清c反应蛋白（CRP）浓度、红细胞沉降率和白细胞计数（WBC）。结果：oltx后组粪便钙保护蛋白明显升高。oltx后组和未移植的PSC-UC组的平均钙保护蛋白值分别为474 ng/ml和180 ng/ml (p = 0.024)，高出163%。66%的肝脏受者和18%的非移植患者钙保护蛋白水平超过正常上限（定义为200 ng/l）（OR = 9.33, p = 0.011）。在oltx后组，CRP浓度（11.01 mg/l vs. 6.54 mg/l, p = 0.30）和WBC （7.58 K/ml vs. 5.72 K/ml, p = 0.006）也高于未移植的PSC-UC组。结论：我们发现PSC- uc患者在因PSC而接受肝移植的患者中炎症标志物明显升高。粪钙保护蛋白水平的影响最大。对于肝移植后PSC-UC患者，尽管临床症状没有恶化，但可能需要加强UC治疗。

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Impact of liver transplantation on intestinal and systemic inflammation markers in patients with colitis ulcerosa concomitant with primary sclerosing cholangitis.

Introduction: Primary sclerosing cholangitis (PSC) is an uncommon, chronic liver disease characterised by fibrosis and strictures of a bile ducts, causing cholestasis. In the long term it can lead to complete stenosis leading in turn to liver cirrhosis. In patients with severe form of the disease, the recommended treatment is liver transplantation. Because PSC frequently coexists with ulcerative colitis (UC), it is crucial to determine the effect of liver transplantation on the course of UC.

Aim: The aim was to determine the impact of liver transplantation on intestinal and systemic inflammation markers with UC concomitant with PSC (PSC-UC).

Material and methods: Sixty-three patients with PSC-UC were enrolled, 25 of whom underwent liver transplantation (OLTx) due to PSC progression. Clinical symptoms, faecal calprotectin levels, C-reactive protein (CRP) serum concentration, erythrocyte sedimentation rate, and white blood cell count (WBC) were obtained.

Results: Faecal calprotectin was significantly higher in the post-OLTx group. Mean calprotectin values were 163% higher - 474 ng/ml and 180 ng/ml (p = 0.024) in the post-OLTx group and in the PSC-UC group without the transplantation, respectively. Calprotectin levels exceeded the upper limit of normal (defined as 200 ng/l) in 66% of liver recipients and in 18% of non-transplanted patients (OR = 9.33, p = 0.011). In the post-OLTx group, also CRP concentration (11.01 mg/l vs. 6.54 mg/l, p = 0.30) and WBC (7.58 K/ml vs. 5.72 K/ml, p = 0.006) were higher than in the PSC-UC group without transplantation.

Conclusions: We found significantly higher inflammation markers in PSC-UC patients who underwent liver transplantation due to PSC. The effect was strongest in faecal calprotectin levels. In PSC-UC patients after liver transplantation, intensification of UC treatment may be needed, despite the lack of worsening of clinical symptoms.

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来源期刊

Przegla̜d Gastroenterologiczny GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

2.20

自引率

7.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Gastroenterology Review is a journal published each 2 months, aimed at gastroenterologists and general practitioners. Published under the patronage of Consultant in Gastroenterology and Polish Pancreatic Club.