J Gastroen Hepatol:肝硬化胃底静脉曲张破裂出血患者急性肾损伤增加死亡风险

2017-10-28 zhangfan MedSci原创

研究发现,胃底静脉曲张破裂出血的肝硬化患者,出现急性肾损伤的现象十分普遍,导致患者6周内的死亡风险增加,急性肾损伤与患者3个月的生存率显著相关

国际肝硬化腹水指南(ICA)是肝硬化患者急性肾损伤(AKI)诊断和治疗的重要临床依据。近日研究人员评估了ICA- AKI的诊断标准与胃底静脉曲张破裂出血(GVB)的肝硬化患者预后的关系。

研究人员对台北荣民总医院,2007-2010年间肝硬化患者首次急性GVB治疗相关数据进行回顾分析,采用COX比例风险模型考察ICA-AKI与患者死亡风险的关系。

113名患者参与研究,其中46人(41%) 满足ICA-AKI,70%的患者处于AKI第1阶段。Child-Pugh评分、入院时血压和术前输血单位数是独立的AKI预测因子。AKI患者中,30%出现进展并导致进展性肝病,其特征为低血钠、输血增加、感染频率高以及血清肌酐升高。AKI患者6周的死亡风险显著高于非AKI患者(37% vs 3%, P < 0.001),且AKI阶段是独立的3个月生存期预测因素(无AKI患者3个月生存率为93%,1阶段为73%,2-3阶段为30%,P = 0.005)。

研究发现,胃底静脉曲张破裂出血的肝硬化患者,出现急性肾损伤的现象十分普遍,导致患者6周内的死亡风险增加,急性肾损伤与患者3个月的生存率显著相关。

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    2018-03-07 fusion
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    2018-07-16 许安
  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/syBKejEucZo9aZXqKib7wdZYRpZOzeEKDyA59Er4fkK2ff1X7w9pfDTWUY75EBCpsNo0iaGqly7sJMtEPI2Pur6Q/0, createdBy=eb672097339, createdName=lucycici, createdTime=Thu Nov 02 07:45:53 CST 2017, time=2017-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=257465, encodeId=f13425e46531, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Tue Oct 31 09:49:47 CST 2017, time=2017-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255692, encodeId=97071255692a8, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426870, encodeId=0f5614268e022, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Sun Oct 29 22:42:00 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256640, encodeId=aa38256640e9, content=学习学习.了解了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Oct 28 11:05:27 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256604, encodeId=19d225660481, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Oct 28 08:26:27 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2017-11-02 lucycici

    了解了解

    0

  5. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426870, encodeId=0f5614268e022, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Sun Oct 29 22:42:00 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256640, encodeId=aa38256640e9, content=学习学习.了解了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Oct 28 11:05:27 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256604, encodeId=19d225660481, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Oct 28 08:26:27 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2017-10-31 大爰

    学习并分享!!

    0

  6. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256604, encodeId=19d225660481, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Oct 28 08:26:27 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
  7. 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  8. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426870, encodeId=0f5614268e022, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Sun Oct 29 22:42:00 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256640, encodeId=aa38256640e9, content=学习学习.了解了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Oct 28 11:05:27 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256604, encodeId=19d225660481, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Oct 28 08:26:27 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2017-10-29 gwc384
  9. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426870, encodeId=0f5614268e022, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Sun Oct 29 22:42:00 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256640, encodeId=aa38256640e9, content=学习学习.了解了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Oct 28 11:05:27 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256604, encodeId=19d225660481, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Oct 28 08:26:27 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2017-10-28 1dd8c52fm63(暂无匿称)

    学习学习.了解了解

    0

  10. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426870, encodeId=0f5614268e022, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Sun Oct 29 22:42:00 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256640, encodeId=aa38256640e9, content=学习学习.了解了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Oct 28 11:05:27 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256604, encodeId=19d225660481, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Oct 28 08:26:27 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2017-10-28 明月清辉

    谢谢分享.学习了

    0

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JACC:经桡动脉或股动脉侵入性治疗急性冠脉综合征后的肾损伤

在接受侵入性治疗的ACS患者中,与FA相比RA与AKI的风险降低相关。

JAHA:IκB激酶抑制剂能显著改善急性肾损伤的肾功能恢复

急性肾损伤(AKI)是导致慢性肾脏疾病的主要危险因素之一。而核因子κB(NF-κB)是一种在缺血后激活的核转录因子,在促炎症蛋白转录方面起到重要作用。但是NF-κB在AKI后肾脏纤维化过程中的作用尚属未知。近日,在国际权威杂志JAHA上发表了一篇旨在研究NF-κB在急性肾损伤后作用机制的研究。本研究利用大鼠模型,将其一侧肾脏切除,并在对侧肾脏做缺血处理30min和再灌注损伤(直到28天),评估其肾

Am J Kidney Dis:八成马拉松参赛选手赛期会出现短暂肾损伤

或许对于热爱马拉松或半马的人而言,生命就是用来奔跑的。不过近期来自耶鲁大学的一项研究显示,82%的马拉松参赛者出现短暂急性肾损伤。

Gastroenterology:质子泵抑制剂与慢性肾损伤

PPI治疗和累积PPI使用与慢性肾脏病进展风险增加相关,该相关风险适中且不能排除残余混杂的影响,需要进一步的验证

Crit Care Med:高氯血症在蛛网膜下腔出血患者中的致命性!

近期,一项发表在杂志CRIT CARE MED上的研究旨在评估蛛网膜下腔出血患者发生急性肾损伤的概率。此项研究招募了所有在2009年至2014年之间诊断为蛛网膜下腔出血的患者,为回顾性分析研究。此项研究共包括了1,267例患者中,其中16.7%发生急性肾损伤(按照“肾脏改善全球成果指标”(仅肌酐变化)所定义)。与没有急性肾损伤的患者相比,急性肾损伤患者的糖尿病(21.2%vs 9.8%; p &l