Baseline MELD Score Predicts Hepatic Decompensation during Antiviral Therapy in Patients with Chronic Hepatitis C and Advanced Cirrhosis.docVIP

下载本文档

4
0
约3.42万字
约 6页
2017-05-07 发布于上海
举报
版权申诉

Baseline MELD Score Predicts Hepatic Decompensation during Antiviral Therapy in Patients with Chronic Hepatitis C and Advanced Cirrhosis.doc

1、本文档共6页，可阅读全部内容。
2、原创力文档（book118）网站文档一经付费（服务费），不意味着购买了该文档的版权，仅供个人/单位学习、研究之用，不得用于商业用途，未经授权，严禁复制、发行、汇编、翻译或者网络传播等，侵权必究。
3、本站所有内容均由合作方或网友上传，本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺！文档内容仅供研究参考，付费前请自行鉴别。如您付费，意味着您自己接受本站规则且自行承担风险，本站不退款、不进行额外附加服务；查看《如何避免下载的几个坑》。如果您已付费下载过本站文档，您可以点击这里二次下载。
4、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等，请点击“版权申诉”（推荐），也可以打举报电话：400-050-0827(电话支持时间：9:00-18:30)。
5、该文档为VIP文档，如果想要下载，成为VIP会员后，下载免费。
6、成为VIP后，下载本文档将扣除1次下载权益。下载后，不支持退款、换文档。如有疑问请联系我们。
7、成为VIP后，您将拥有八大权益，权益包括：VIP文档下载权益、阅读免打扰、文档格式转换、高级专利检索、专属身份标志、高级客服、多端互通、版权登记。
8、VIP文档为合作方或网友上传，每下载1次，网站将根据用户上传文档的质量评分、类型等，对文档贡献者给予高额补贴、流量扶持。如果你也想贡献VIP文档。上传文档

Baseline MELD Score Predicts Hepatic Decompensation during Antiviral Therapy in Patients with Chronic Hepatitis C and Advanced Cirrhosis

BaselineMELDScorePredictsHepaticDecompensation duringAntiviralTherapyinPatientswithChronic HepatitisCandAdvancedCirrhosis GeorgDultz1,MartinSeelhof1,EvaHerrmann2,Martin-WalterWelker1,MireenFriedrich-Rust1, GerlindeTeuber3,BerndKronenberger1,MichaelvonWagner1,JohannesVermehren1, ChristophSarrazin1,StefanZeuzem1,WolfPeterHofmann4* 1Medizinische Klinik 1, Klinikum der Goethe-Universita¨t, Frankfurt am Main, Germany, 2Institut fu¨r Biostatistik und mathematische Modellierung, Goethe-Universita¨t, FrankfurtamMain,Germany,3Interdisziplina¨res FacharztzentrumSachsenhausen,FrankfurtamMain,Germany,4POLIKUMGesundheitszentrenBerlin,Berlin,Germany Abstract BackgroundandAims:InpatientswithadvancedlivercirrhosisduetochronichepatitisCvirus(HCV)infectionantiviral therapywithpeginterferon andribavirinis feasibleinselected casesonlyduetopotentiallylife-threatening side effects. However,predictivefactorsassociatedwithhepaticdecompensationduringantiviraltherapyarepoorlydefined. Methods:Inaretrospectivecohortstudy,68patientswithHCV-associatedlivercirrhosis(meanMELDscore9.1862.72)were treated with peginterferon and ribavirin. Clinical events indicating hepatic decompensation (onset of ascites, hepatic encephalopathy,uppergastrointestinalbleeding,hospitalization)aswellaslaboratorydatawererecordedatbaselineand duringafollowupperiodof72weeksafterinitiationofantiviraltherapy.Tomonitorlongtermsequelaeofendstageliver diseaseanextendedfollowupforHCCdevelopment,transplantationanddeathwasapplied(240weeks,6SD136weeks). Results: Eighteen patients (26.5%) achieved a sustained virologic response. During the observational period a hepatic decompensation was observed in 36.8%.Patients with hepatic decompensation hadhigher MELD scores (10.84vs. 8.23, p,0.001)andhighermeanbilirubinlevels(26.74vs.14.63mmol/l,p,0.001),aswellaslowerserumalbuminlevels(38.2vs. 41.1g/l, p=0.015), mean platelets (102.64 vs. 138.95/nl, p=0.014) and mean leukocytes (4.02 vs. 5.68/nl, p=0.002) at baseline as compared to t