Predictive factors in ursodeoxycholic acid‐treated patients with primary biliary Cirrhosis: Role of serum markers of connective tissue
Predictive factors in ursodeoxycholic acid‐treated patients with primary biliary Cirrhosis: Role of serum markers of connective tissue
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熊去氧胆酸治疗的原发性胆汁性肝硬化患者的预测因素：结缔组织血清标志物的作用
DOI：
10.1002/hep.1840190314
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发表时间：
1994
期刊：
影响因子：
13.5
通讯作者：
F. Heintzmann
中科院分区：
文献类型：
--
作者：
R. Poupon;B. Balkau;J. Guéchot;F. Heintzmann
这项研究的目的是确定在接受熊去氧胆酸治疗的原发性胆汁性肝硬变患者中，以高胆红素血症或严重临床并发症的发生为定义的终末期发病的预测因素。本研究中97名原发性胆汁性肝硬变患者参加了为期两年的临床试验。接受熊去氧胆酸(每天13至15毫克/公斤)治疗的49名患者中有4名进入了疾病的晚期，相比之下，48名接受安慰剂治疗的患者中有9名进入了晚期。除了临床、常规生物学和组织学参数外，我们还分析了结缔组织成分的三个血清标志物--III型前胶原氨基端肽、透明质酸和层粘连蛋白。在熊去氧胆酸治疗组中，透明质酸、III型前胶原氨基端肽、胆红素和脾肿大是与疾病进入终末期关系最密切的因素。在多变量分析中，调整年龄后，透明质酸水平是唯一的预测因素。安慰剂组胆红素、总胆汁酸、Mayo评分、III型前胶原氨基端肽、透明质酸、脾肿大、瘙痒与病情加重有关。在多因素分析中，高胆红素水平、高III型前胶原氨基端肽或透明质酸水平、低凝血酶原时间独立提示预后不良。总之，当原发性胆汁性肝硬变患者接受熊去氧胆酸治疗时，胆红素血症在一定程度上失去了它的预测价值。它被透明质酸和III型前胶原氨基端肽取代。这表明，用于决定是否需要肝移植的模型需要适应接受熊去氧胆酸治疗的患者。(肝病1994；19：635-640)。
The aim of this study was to define factors predictive of the onset of the terminal phase, defined by hyperbilirubinemia or the occurrence of a severe clinical complication, in patients with primary biliary cirrhosis treated with ursodeoxycholic acid. The 97 primary biliary cirrhosis patients in this study participated in a 2‐yr clinical trial. Four of the 49 patients treated with ursodeoxycholic acid (13 to 15 mg/kg/day) entered the terminal phase of the disease, compared with 9 of the 48 patients assigned to placebo. In addition to clinical, conventional biological and histological parameters, we analyzed three serum markers of connective tissue components‐type III procollagen aminoterminal peptide, hyaluronic acid and laminin. In the ursodeoxycholic acid‐treated group, hyaluronic acid, type III procollagen aminoterminal peptide, bilirubin and splenomegaly were the factors most closely associated with entry into the terminal phase of the disease. In multivariate analysis, after adjustment for age, the hyaluronic acid level was the only predictive factor. In the placebo‐treated group, the bilirubin level, total bile acid level, Mayo score, type III procollagen aminoterminal peptide, hyaluronic acid, splenomegaly and pruritus were associated with aggravation of disease. In multivariate analysis, high bilirubin level, high type III procollagen aminoterminal peptide or hyaluronic acid levels and low prothrombin time independently implied poor prognosis. In conclusion, when patients with primary biliary cirrhosis are treated with ursodeoxycholic acid, bilirubinemia loses, in part, its predictive value. It is replaced by hyaluronic acid and type III procollagen aminoterminal peptide. This suggests that models used in deciding on the need for liver transplantation require adaptation for patients receiving ursodeoxycholic acid. (Hepatology 1994;19:635–640).
DOI：
--
发表时间：
1972
期刊：
--
影响因子：
--
作者：
D. Cox
通讯作者：
D. Cox