Primary biliary cirrhosis: Incidence and predictive factors of cirrhosis development in ursodiol-treated patients

被引:130
作者
Corpechot, C
Carrat, F
Poupon, R
Poupon, RE
机构
[1] Hop St Antoine, INSERM, F-75571 Paris, France
[2] Hop Necker Enfants Malad, INSERM U370, Paris, France
关键词
D O I
10.1053/gast.2002.31880
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: Ursodeoxycholic acid (UDCA) slows the progression of primary billary cirrhosis (PBC). However, some UDCA-treated patients escape and progress toward cirrhosis and end-stage disease. This study aimed to assess the incidence of cirrhosis in UDCA-treated patients with PBC and to determine the predictive factors of cirrhosis development under this treatment. Methods: A Markov model was used to describe the progression toward cirrhosis in 183 UDCA-treated patients with PBC. A total of 254 pairs of liver biopsy specimens collected during 655 patient-years were studied. Results: The incidence of cirrhosis after 5 years of UDCA treatment was 4%, 12%, and 59% among patients followed-up from stages I, II, and III, respectively. At 10 years, the incidence, was 17%, 27%, and 76%, respectively. The median time for developing cirrhosis from stages I, II, and III was 25 years, 20 years, and 4 years, respectively. The independent predictive factors of cirrhosis development were serum bilirubin greater than 17 mumol/L, serum albumin less than 38 g/L, and moderate to severe lymphocytic piecemeal necrosis. Conclusions: This study provides new data about the time course of PBC under UDCA and constitutes a rationale for the design and evaluation of clinical trials aimed to assess the efficacy of drugs associated with UDCA.
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页码:652 / 658
页数:7
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