...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Liver international : >Biochemical markers of liver fibrosis and lymphocytic piecemeal necrosis in UDCA-treated patients with primary biliary cirrhosis.
【24h】

Biochemical markers of liver fibrosis and lymphocytic piecemeal necrosis in UDCA-treated patients with primary biliary cirrhosis.

机译：UDCA治疗的原发性胆汁性肝硬化患者肝纤维化和淋巴细胞性小块坏死的生化标志物。

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND/AIM: We have previously shown that the histological stage and severity of lymphocytic piecemeal necrosis (LPN) are independent predictive factors of cirrhosis development in ursodeoxycholic acid (UDCA)-treated patients with primary biliary cirrhosis (PBC). Our aim during this study was to determine whether biochemical parameters classically used in PBC management and measured under UDCA could be considered as reliable surrogate markers for these histological prognostic indices in clinical practice. METHOD: The study included 153 patients with PBC who had undergone a control liver biopsy after 2 years of UDCA therapy. The relationships between histological and biological features were assessed by variance analysis and logistic regression. The diagnostic value of independent markers was assessed in terms of their sensitivity, specificity, positive predictive value (PPV) and negative value (NPV) and receiver-operating characteristic curves. RESULTS: Two variables were independently associated with extensive fibrosis (i.e. advanced histological stages): serum levels of bilirubin and hyaluronic acid (HA). A fibrosis index ([bilirubin (micromol/l)/14]+[HA (microg/l)/143]) higher than 1.5 exhibited good PPV and specificity (>74%) but rather poor NPV and sensitivity (<64%) regarding a diagnosis of extensive fibrosis. The only independent marker of LPN was aspartate aminotransferase (AST) activity. AST activity of more than twice the upper limit of normal showed acceptable PPV (>70%) but very low sensitivity (<25%) for a diagnosis of LPN. CONCLUSIONS: Serum bilirubin and HA levels measured under UDCA therapy are of acceptable diagnostic value for extensive fibrosis, but none of the biochemical tests commonly employed in the management of PBC can be considered as surrogate markers of LPN. Taken together with our previous results, these findings suggest that liver biopsy may be necessary to screen UDCA-treated patients who might require additional therapies.
机译：背景/目的：我们先前已经证明，在熊去氧胆酸（UDCA）治疗的原发性胆汁性肝硬化（PBC）患者中，淋巴细胞性小块坏死（LPN）的组织学阶段和严重程度是肝硬化发展的独立预测因素。我们在这项研究中的目的是确定在临床实践中，传统上用于PBC管理并在UDCA下测量的生化参数是否可以被视为这些组织学预后指标的可靠替代指标。方法：该研究纳入153名UDCA治疗2年后行对照肝活检的PBC患者。组织和生物学特征之间的关系通过方差分析和逻辑回归进行评估。根据独立标记的敏感性，特异性，阳性预测值（PPV）和阴性值（NPV）以及接受者操作特征曲线评估其诊断价值。结果：两个变量与广泛纤维化（即晚期组织学阶段）独立相关：血清胆红素和透明质酸（HA）水平。高于1.5的纤维化指数（[胆红素（micromol / l）/ 14] + [HA（microg / l）/ 143]）表现出良好的PPV和特异性（> 74％），但不良的NPV和敏感性（<64％）关于广泛纤维化的诊断。 LPN的唯一独立标记是天冬氨酸转氨酶（AST）活性。 AST活性是正常上限的两倍以上，显示可接受的PPV（> 70％），但对LPN的诊断灵敏度非常低（<25％）。结论：在UDCA治疗下测得的血清胆红素和HA水平对广泛的纤维化具有可接受的诊断价值，但是在PBC管理中常用的生化检验均不能视为LPN的替代指标。结合我们先前的结果，这些发现表明，肝活检可能是筛查UDCA治疗的患者的必要方法，这些患者可能需要其他治疗方法。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号