کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6104213 1211136 2014 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Research ArticleDetection of early portal hypertension with routine data and liver stiffness in patients with asymptomatic liver disease: A prospective study
ترجمه فارسی عنوان
مقاله پژوهشی کشف پرفشاری خون ابتدایی پورتال با داده های روتین و سفتی کبد در بیماران مبتلا به بیماری بدون علامت کبدی: یک مطالعه آینده نگر
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های گوارشی
چکیده انگلیسی

Background & AimsDetecting portal hypertension (PH) before the development of varices is important for prognosis and for designing interventional studies. None of the available strategies is used in practice. We evaluated a sequential screening-diagnostic strategy based on clinical data and transient elastography (TE) to detect PH in asymptomatic outpatients with liver disease.MethodsConsecutive patients with chronic liver disease and no previous diagnosis of PH were screened by TE. Patients with liver stiffness (LS) ⩾13.6 kPa were further evaluated by endoscopy and hepatic venous pressure gradient (HVPG). For analysis, patients were classified in 3 groups: group A, platelets ⩾150,000/mm3, normal abdominal ultrasound; group B, platelets <150,000/mm3, normal ultrasound; group C, platelets <150,000/mm3, abnormal ultrasound (splenomegaly, nodular liver surface).Results250 patients were evaluated (69% group A, 20% group B, 11% group C). In 9% elastography was non-valid. LS ⩾13.6 was found in 54 patients (8% A, 43% B, and 81% C, p <0.001). Endoscopy was performed in 49 of these: 20% had small varices, 0% high-risk varices. No patients from group A had varices, and 90% with varices belonged to group C. HVPG was obtained in 40 patients: 93% had PH (HVPG >5 mmHg) and 65% clinically significant PH (CSPH, HVPG ⩾10). Only 3 patients, all from group A, had HVPG <5. All patients from groups B and C with LS ⩾13.6 had PH. The LS 25 cut-off was excellent at ruling-in CSPH.ConclusionsA simple strategy based on routine clinical data and TE could be useful to detect early PH among asymptomatic patients with chronic liver disease.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Hepatology - Volume 60, Issue 3, March 2014, Pages 561-569
نویسندگان
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