Natural history of decompensated hepatitis C virus-related cirrhosis.: A study of 200 patients
Natural history of decompensated hepatitis C virus-related cirrhosis.: A study of 200 patients
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DOI：
10.1016/j.jhep.2004.01.005
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发表时间：
2004-05-01
影响因子：
25.7
通讯作者：
Sola, R
中科院分区：
文献类型：
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作者：
Planas, R;Ballesté, B;Sola, R
背景/目标：由于关于失代偿性丙型肝炎病毒（HCV）相关肝硬化的临床过程的数据很少，本研究的目的是确定首次肝失代偿后的自然长期过程。方法：队列200例连续的HCV相关肝硬化患者，没有已知的肝细胞癌（HCC），因首次肝失代偿而住院。腹水是最常见的首次失代偿（48%），其次是门静脉高压性消化道出血（PHGB）（32.5%），严重细菌感染（BI）（14.5%）和肝性脑病（HE）（5%）。在随访期间（34+/-2个月），有519例再入院，33例（16.5%）患者发生HCC，85例（42.5%）患者死亡。失代偿期肝硬化诊断后1年和5年生存率分别为81.8%和50.8%。HE和/或腹水作为第一个肝失代偿，基线Child-Pugh评分，年龄，并存在一个以上的失代偿期随访期间独立相关survival.Conclusions：一旦失代偿HCV相关肝硬化成立，患者不仅表现出非常高的频率再入院，但也开发失代偿期不同于最初的。这些结果有助于确定失代偿期HCV相关肝硬化的自然病程和预后。(C)2004年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background/Aims: Since few data are available concerning the clinical course of decompensated hepatitis C virus (HCV)-related cirrhosis, the aim of the present study was to define the natural long-term course after the first hepatic decompensation.Methods: Cohort of 200 consecutive patients with HCV-related cirrhosis, and without known hepatocellular carcinoma (HCC), hospitalized for the first hepatic decompensation.Results: Ascites was the most frequent first decompensation (48%), followed by portal hypertensive gastrointestinal bleeding (PHGB) (32.5%), severe bacterial infection (BI) (14.5%) and hepatic encephalopathy (HE) (5%). During follow-up (34+/-2 months) there were 519 readmissions, HCC developed in 33 (16.5%) patients, and death occurred in 85 patients (42.5%). The probability of survival after diagnosis of decompensated cirrhosis was 81.8 and 50.8 % at 1 and 5 years, respectively. HE and/or ascites as the first hepatic decompensation, baseline Child-Pugh score, age, and presence of more than one decompensation during follow-up were independently correlated with survival.Conclusions: Once decompensated HCV-related cirrhosis was established, patients showed not only a very high frequency of readmissions, but also developed decompensations different from the initial one. These results contribute to defining the natural course and prognosis of decompensated HCV-related cirrhosis. (C) 2004 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.