Essential hypertension and chronic viral hepatitis
Essential hypertension and chronic viral hepatitis
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DOI：
10.1016/j.dld.2007.01.009
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发表时间：
2007-05-01
影响因子：
4.5
通讯作者：
Marchesini, G.
中科院分区：
文献类型：
--
作者：
Parrilli, G.;Manguso, F.;Marchesini, G.
客观的。高血压和慢性肝炎都是常见疾病。动脉压与肝硬化之间的关系已得到广泛研究，但尚无针对慢性肝炎（CH）的研究。最近，一些研究报道，常用于治疗动脉高血压的血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARB）可以减少病毒性慢性肝炎和非酒精性脂肪性肝炎患者的肝纤维化。本研究旨在比较伴有/不伴有原发性高血压的患者病毒后 CH 的演变。方法。进行了两组观察：(a) 对 95 名病毒性 CH 患者进行横断面队列研究，比较诊断时与药物治疗的原发性高血压相关的组织学和生化数据的严重程度；(b) 一项回顾性研究，观察 254 名病毒性 CH 患者的病毒病因，随访 2 至 20 年，以确定病毒性 CH 与治疗的原发性高血压相关的自然史。 结果。在横断面分析中，接受治疗的高血压患者诊断 CH 时的年龄明显较大（51.4 +/- 8.4 岁，血压正常时为 46.2 +/- 12.2 岁；P < 0.001），且组织学证据显示坏死性炎症性肝损伤较轻。 ALT 水平也较低（血压正常时为 109.8 +/- 62.5 U/L 对比 166.0 +/- 169.5；P < 0.001），内皮素-1 水平也较低（0.74 +/- 0.97 对比 1.77 +/- 1.51 fmol/mL；P < 0.001）。回顾性研究证实，接受治疗的高血压患者的诊断年龄较高（48.7 +/- 9.8 vs. 41.9 +/- 11.8 岁；P < 0.001），死亡率较低（2.2% vs. 11%；P < 0.05）。结论。在患有原发性高血压的受试者中，病毒后慢性肝炎的演变似乎不太严重，这可能与抗高血压药物的治疗有关。 (C) 2007 年 Editrice Gastroenterologica Italiana S.r.l.由爱思唯尔有限公司出版。保留所有权利。
Objective. Both arterial hypertension and chronic hepatitis are common disorders. The relationship between arterial pressure and liver cirrhosis has been extensively studied, but no studies are available in chronic hepatitis (CH). Recently, a few studies have reported that treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs), commonly used in arterial hypertension, reduce hepatic fibrosis in patients with viral CH and in nonalcoholic steatohepatitis. This study was aimed at comparing the evolution of post-viral CH in patients with/without concomitant essential hypertension.Methods. Two sets of observations were carried out: (a) a cross-sectional cohort study of 95 patients with viral CH, to compare the severity of histological and biochemical data at diagnosis, in relation to pharmacologically treated essential hypertension, and (b) a retrospective study with the observation of 254 patients with CH of viral etiology, followed up from 2 to 20 years, to establish the natural history of viral CH in relation to treated essential hypertension.Results. In the cross-sectional analysis, patients with treated hypertension had a significantly older age at diagnosis of CH (51.4 +/- 8.4 years vs. 46.2 +/- 12.2 in normotensive; P < 0.001) and histological evidence of less severe necro-inflammatory liver damage. ALT levels were also lower (109.8 +/- 62.5 U/L vs. 166.0 +/- 169.5 in normotensive; P < 0.001) as were endothelin-1 levels (0.74 +/- 0.97 vs. 1.77 +/- 1.51 fmol/mL; P < 0.001). The retrospective study confirmed an older age at diagnosis in patients with treated hypertension (48.7 +/- 9.8 vs. 41.9 +/- 11.8 years; P < 0.001) and lower death rates (2.2% vs. 11%; P < 0.05).Conclusions. The evolution of post-viral CH seems to be less severe in subjects with essential hypertension, possibly in relation to treatment with antihypertensive drugs. (C) 2007 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.