Biochemical response to ursodeoxycholic acid predicts long-term outcome in Japanese patients with primary biliary cirrhosis
Biochemical response to ursodeoxycholic acid predicts long-term outcome in Japanese patients with primary biliary cirrhosis
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DOI：
10.1111/j.1872-034x.2011.00782.x
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发表时间：
2011-04-01
影响因子：
4.2
通讯作者：
Onji, Morikazu
中科院分区：
文献类型：
--
作者：
Azemoto, Nobuaki;Kumagi, Teru;Onji, Morikazu
目的：目前对原发性胆汁性肝硬化（PBC）患者长期预后的预测指标有着持续的需求。我们的研究组（爱媛标准）引入了对熊去氧胆酸（UDCA）的生化反应来预测症状的发展，并预测西方国家的长期结局（巴黎、巴塞罗那和鹿特丹标准）。本研究的目的是评估这些标准是否也是有用的，以预测长期的结果在日本患者PBC.Methods：一个回顾性的图表审查进行了227例日本PBC患者。研究纳入了观察期超过6个月的服用UDCA的患者。数据收集包括人口统计学、生化和血清学标志物以及组织学分期。四个不同的标准进行比较和评价生化反应UDCA。结果：在总数，138例患者符合纳入标准，并进行了分析。使用Ehime标准，反应者的无移植存活率显著高于无反应者（P = 0.010）。巴黎标准也预测了我们人群的长期结局（P = 0.003），而Barcelona和鹿特丹标准显示没有这种关联（分别为P = 0.282和P = 0.553）。结论：根据Ehime和巴黎标准，UDCA的良好生化应答与日本PBC患者的长期结局相关，并允许识别可能从进一步试验中获益的无应答者。最后，爱媛标准应在不同的患者队列中进行验证。
Aim:There is an ongoing need for predictors of long-term outcomes for patients with primary biliary cirrhosis (PBC). Biochemical response to ursodeoxycholic acid (UDCA) has been introduced to predict development of symptoms by our group (Ehime criteria) and to predict long-term outcomes in Western countries (Paris, Barcelona and Rotterdam criteria). The aim of this study was to evaluate whether these criteria are also useful to predict long-term outcomes in Japanese patients with PBC.Methods:A retrospective chart review was conducted for 227 Japanese patients with PBC. Patients taking UDCA with an observation period of more than 6 months were included in the study. Data collection included demographics, biochemical and serological markers, and histological stage. Four different criteria regarding biochemical response to UDCA were compared and evaluated.Results:In total, 138 patients met the inclusion criteria and underwent analysis. Using the Ehime criteria, the transplant-free survival rate was significantly higher in responders than in non-responders (P = 0.010). The Paris criteria also predicted long-term outcomes in our population (P = 0.003), whereas the Barcelona and Rotterdam criteria showed no such association (P = 0.282 and P = 0.553, respectively).Conclusion:Good biochemical response to UDCA according to the Ehime and Paris criteria is associated with long-term outcome in Japanese patients with PBC and allows identification of non-responders who may benefit from further trials. Finally, Ehime criteria should be validated in a different patient cohort.