Liver Function Test Abnormalities in Patients with Inflammatory Bowel Diseases: A Hospital-based Survey
Liver Function Test Abnormalities in Patients with Inflammatory Bowel Diseases: A Hospital-based Survey
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DOI：
10.4137/cgast.s13125
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发表时间：
2014-01-01
影响因子：
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通讯作者：
Almasio, Piero Luigi
中科院分区：
文献类型：
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作者：
Cappello, Maria;Randazzo, Claudia;Almasio, Piero Luigi
背景和目的：炎症性肠病（IBD）经常与肝功能检查（LFT）改变相关。LFT异常与IBD之间的因果关系尚不清楚。我们研究的目的是评估LFT异常的患病率和病因及其与IBD患者在一个单一center.MATERIALS和METHODS随访队列中的临床变量的关系：进行回顾性分析，所有连续IBD的住院和门诊患者常规随访在一个单一的转诊中心。记录临床和人口统计学参数。如果受试者既往诊断为慢性肝病，则将其排除。LFT异常被定义为天冬氨酸转氨酶（AST），丙氨酸转氨酶（ALT），碱性磷酸酶（ALP），γ-谷氨酰转肽酶（GGT），或总bilirin.Results的增加：一个队列的335例患者（179名男性，平均年龄46.0 +/- 15.6岁）进行了分析。70例患者（20.9%）检测到LFT异常。在大多数情况下，改变是轻微的，约60%的患者自发恢复正常值。异常LFT患者在氨基水杨酸盐治疗中的发生率较低（22.8% vs. 36.6%，P = 0.04）。一过性LFT异常的最常见原因是药物性胆汁淤积（34.1%），而脂肪肝是持续性肝损害的最常见原因（65.4%）。胆汁淤积的模式被发现在60.0%的患者，主要与年龄较大，病程较长，高血压。结论：LFT异常的患病率是相对较高的IBD患者，但严重的肝损伤的发展是例外。此外，大多数LFT的改变是轻微的，并且自发地恢复到正常值。药物性肝毒性和脂肪肝是IBD患者LFT异常的最相关原因。
BACKGROUND AND AIMS: Inflammatory bowel diseases (IBD) are frequently associated with altered liver function tests (LFTs). The causal relationship between abnormal LFTs and IBD is unclear. The aim of our study was to evaluate the prevalence and etiology of LFTs abnormalities and their association with clinical variables in a cohort of IBD patients followed up in a single center.MATERIALS AND METHODS: A retrospective review was undertaken of all consecutive IBD in-and outpatients routinely followed up at a single referral center. Clinical and demographic parameters were recorded. Subjects were excluded if they had a previous diagnosis of chronic liver disease. LFT abnormality was defined as an increase in aspartate aminotransferase, (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gammaglutamyl transpeptidase (GGT), or total bilirubin.RESULTS: A cohort of 335 patients (179 males, mean age 46.0 +/- 15.6 years) was analyzed. Abnormal LFTs were detected in 70 patients (20.9%). In most cases, the alterations were mild and spontaneously returned to normal values in about 60% of patients. Patients with abnormal LFTs were less frequently on treatment with aminosalicylates (22.8 vs. 36.6%, P = 0.04). The most frequent cause for transient abnormal LFTs was drug-induced cholestasis (34.1%), whereas fatty liver was the most frequent cause of persistent liver damage (65.4%). A cholestatic pattern was found in 60.0% of patients and was mainly related to older age, longer duration of disease, and hypertension.CONCLUSIONS: The prevalence of LFT abnormalities is relatively high in IBD patients, but the development of severe liver injury is exceptional. Moreover, most alterations of LFTs are mild and spontaneously return to normal values. Drug-induced hepatotoxicity and fatty liver are the most relevant causes of abnormal LFTs in patients with IBD.