Anru Zhou, Binlin Da, Wenting Lu, Chuanfu Ding, Chunxiang Wang, Zihao Cai, Qin Yin, Jiangqiang Xiao, Ming Zhang, Junhui Chen, Lei Wang, Feng Zhang, Yuzheng Zhuge
{"title":"血清腹水白蛋白梯度预测吡咯利西啶类生物碱所致肝窦梗阻综合征严重程度的研究。","authors":"Anru Zhou, Binlin Da, Wenting Lu, Chuanfu Ding, Chunxiang Wang, Zihao Cai, Qin Yin, Jiangqiang Xiao, Ming Zhang, Junhui Chen, Lei Wang, Feng Zhang, Yuzheng Zhuge","doi":"10.5114/ceh.2025.151628","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim of the study: </strong>Hepatic sinusoidal obstruction syndrome induced by pyrrolizidine alkaloids (PA-HSOS) is a form of drug-induced liver injury (DILI) associated with portal hypertension (PH). The serum-ascites albumin gradient (SAAG) is known to be directly related to PH. However, the clinical value of SAAG for predicting the severity of PA-HSOS is unknown. We aimed to evaluate the association between SAAG and hepatic venous pressure gradient (HVPG) and portal pressure (PP) in patients with PA-HSOS and to investigate the clinical value of SAAG for predicting the severity of PA-HSOS.</p><p><strong>Material and methods: </strong>We retrospectively collected the clinical data from all patients with PA-HSOS undergoing PP measurement and abdominocentesis between January 2015 and December 2021. Pearson's correlation (R), intraclass correlation coefficient (ICC), and scatter plot analysis were performed to evaluate associations.</p><p><strong>Results: </strong>In total, 28 patients were analyzed. The correlation between SAAG and HVPG was moderate (<i>R</i> = 0.41, ICC = 0.40, <i>p</i> = 0.031), while the correlation between SAAG and wedge hepatic vein pressure (WHVP) was poor (<i>R</i> = 0.36, ICC = 0.34, <i>p</i> = 0.060). The correlation between SAAG and portal pressure gradient (PPG) was moderate (<i>R</i> = 0.49, ICC = 0.42, <i>p</i> = 0.030), while the correlation between SAAG and portal pressure was good (<i>R</i> = 0.57, ICC = 0.52, <i>p</i> = 0.008). SAAG differed significantly different between mild and moderate/severe patients according to the Drum Tower Severity Scoring (DTSS) system (15.3 vs. 17.7 g/l, <i>p</i> = 0.042).</p><p><strong>Conclusions: </strong>The SAAG provides a simple and minimally invasive method for predicting the severity of PA-HSOS, and may facilitate prognostic prediction and treatment decisions.</p>","PeriodicalId":10281,"journal":{"name":"Clinical and Experimental Hepatology","volume":"11 2","pages":"152-159"},"PeriodicalIF":1.7000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403773/pdf/","citationCount":"0","resultStr":"{\"title\":\"Serum ascites albumin gradient in predicting the severity of hepatic sinusoidal obstruction syndrome induced by pyrrolizidine alkaloids.\",\"authors\":\"Anru Zhou, Binlin Da, Wenting Lu, Chuanfu Ding, Chunxiang Wang, Zihao Cai, Qin Yin, Jiangqiang Xiao, Ming Zhang, Junhui Chen, Lei Wang, Feng Zhang, Yuzheng Zhuge\",\"doi\":\"10.5114/ceh.2025.151628\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim of the study: </strong>Hepatic sinusoidal obstruction syndrome induced by pyrrolizidine alkaloids (PA-HSOS) is a form of drug-induced liver injury (DILI) associated with portal hypertension (PH). The serum-ascites albumin gradient (SAAG) is known to be directly related to PH. However, the clinical value of SAAG for predicting the severity of PA-HSOS is unknown. We aimed to evaluate the association between SAAG and hepatic venous pressure gradient (HVPG) and portal pressure (PP) in patients with PA-HSOS and to investigate the clinical value of SAAG for predicting the severity of PA-HSOS.</p><p><strong>Material and methods: </strong>We retrospectively collected the clinical data from all patients with PA-HSOS undergoing PP measurement and abdominocentesis between January 2015 and December 2021. Pearson's correlation (R), intraclass correlation coefficient (ICC), and scatter plot analysis were performed to evaluate associations.</p><p><strong>Results: </strong>In total, 28 patients were analyzed. The correlation between SAAG and HVPG was moderate (<i>R</i> = 0.41, ICC = 0.40, <i>p</i> = 0.031), while the correlation between SAAG and wedge hepatic vein pressure (WHVP) was poor (<i>R</i> = 0.36, ICC = 0.34, <i>p</i> = 0.060). The correlation between SAAG and portal pressure gradient (PPG) was moderate (<i>R</i> = 0.49, ICC = 0.42, <i>p</i> = 0.030), while the correlation between SAAG and portal pressure was good (<i>R</i> = 0.57, ICC = 0.52, <i>p</i> = 0.008). SAAG differed significantly different between mild and moderate/severe patients according to the Drum Tower Severity Scoring (DTSS) system (15.3 vs. 17.7 g/l, <i>p</i> = 0.042).</p><p><strong>Conclusions: </strong>The SAAG provides a simple and minimally invasive method for predicting the severity of PA-HSOS, and may facilitate prognostic prediction and treatment decisions.</p>\",\"PeriodicalId\":10281,\"journal\":{\"name\":\"Clinical and Experimental Hepatology\",\"volume\":\"11 2\",\"pages\":\"152-159\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403773/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Hepatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5114/ceh.2025.151628\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Hepatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5114/ceh.2025.151628","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
研究目的:吡罗里西定生物碱(PA-HSOS)引起的肝窦阻塞综合征是一种与门静脉高压(PH)相关的药物性肝损伤(DILI)。已知血清-腹水白蛋白梯度(SAAG)与ph直接相关。然而,SAAG在预测PA-HSOS严重程度方面的临床价值尚不清楚。我们的目的是评估SAAG与PA-HSOS患者肝静脉压力梯度(HVPG)和门静脉压力(PP)之间的关系,并探讨SAAG在预测PA-HSOS严重程度方面的临床价值。材料和方法:我们回顾性收集2015年1月至2021年12月期间所有接受PP测量和腹腔穿刺术的PA-HSOS患者的临床资料。采用Pearson相关(R)、类内相关系数(ICC)和散点图分析来评价相关性。结果:共分析28例患者。SAAG与HVPG相关性中等(R = 0.41, ICC = 0.40, p = 0.031), SAAG与肝静脉楔压(WHVP)相关性较差(R = 0.36, ICC = 0.34, p = 0.060)。SAAG与门静脉压力梯度(PPG)相关性中等(R = 0.49, ICC = 0.42, p = 0.030), SAAG与门静脉压力相关性较好(R = 0.57, ICC = 0.52, p = 0.008)。根据鼓楼严重程度评分(DTSS)系统,轻度和中度/重度患者SAAG差异显著(15.3 g/l vs. 17.7 g/l, p = 0.042)。结论:SAAG为预测PA-HSOS严重程度提供了一种简单、微创的方法,有助于预后预测和治疗决策。
Serum ascites albumin gradient in predicting the severity of hepatic sinusoidal obstruction syndrome induced by pyrrolizidine alkaloids.
Aim of the study: Hepatic sinusoidal obstruction syndrome induced by pyrrolizidine alkaloids (PA-HSOS) is a form of drug-induced liver injury (DILI) associated with portal hypertension (PH). The serum-ascites albumin gradient (SAAG) is known to be directly related to PH. However, the clinical value of SAAG for predicting the severity of PA-HSOS is unknown. We aimed to evaluate the association between SAAG and hepatic venous pressure gradient (HVPG) and portal pressure (PP) in patients with PA-HSOS and to investigate the clinical value of SAAG for predicting the severity of PA-HSOS.
Material and methods: We retrospectively collected the clinical data from all patients with PA-HSOS undergoing PP measurement and abdominocentesis between January 2015 and December 2021. Pearson's correlation (R), intraclass correlation coefficient (ICC), and scatter plot analysis were performed to evaluate associations.
Results: In total, 28 patients were analyzed. The correlation between SAAG and HVPG was moderate (R = 0.41, ICC = 0.40, p = 0.031), while the correlation between SAAG and wedge hepatic vein pressure (WHVP) was poor (R = 0.36, ICC = 0.34, p = 0.060). The correlation between SAAG and portal pressure gradient (PPG) was moderate (R = 0.49, ICC = 0.42, p = 0.030), while the correlation between SAAG and portal pressure was good (R = 0.57, ICC = 0.52, p = 0.008). SAAG differed significantly different between mild and moderate/severe patients according to the Drum Tower Severity Scoring (DTSS) system (15.3 vs. 17.7 g/l, p = 0.042).
Conclusions: The SAAG provides a simple and minimally invasive method for predicting the severity of PA-HSOS, and may facilitate prognostic prediction and treatment decisions.
期刊介绍:
Clinical and Experimental Hepatology – quarterly of the Polish Association for Study of Liver – is a scientific and educational, peer-reviewed journal publishing original and review papers describing clinical and basic investigations in the field of hepatology.