PDF(Pubmed)
Abstract：
UNASSIGNED: A high aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio is associated with liver injury in liver disease; however, no data exist regarding its relationship with 90-day prognosis in patients with acute exacerbation of chronic liver disease.
UNASSIGNED: In this study, 3,758 participants (955 with advanced fibrosis and 2,803 with cirrhosis) from the CATCH-LIFE cohort in China were included. The relationships between different AST/ALT ratios and the risk of adverse 90-day outcomes (death or liver transplantation) were determined in patients with cirrhosis or hepatitis B virus (HBV)-associated advanced fibrosis, respectively.
UNASSIGNED: In the patients with HBV-associated advanced fibrosis, the risk of 90-day adverse outcomes increased with AST/ALT ratio; after adjusting for all confounding factors, the risk of adverse 90-day outcomes was the highest when AST/ALT ratio was more than 1.08 (OR = 6.91 [95% CI = 1.789-26.721], p = 0.005), and the AST/ALT ratio of >1.9 accelerated the development of adverse outcomes. In patients with cirrhosis, an AST/ALT ratio > 1.38 increased the risk of adverse 90-day outcomes in all univariables (OR = 1.551 [95% CI = 1.216-1.983], p < 0.001) and multivariable-adjusted analyses (OR = 1.847 [95% CI = 1.361-2.514], p < 0.001), and an elevated AST/ALT ratio (<2.65) accelerated the incidence of 90-day adverse outcomes. An AST/ALT ratio of >1.38 corresponded with a more than 20% incidence of adverse outcomes in patients with cirrhosis.
UNASSIGNED: The AST/ALT ratio is an independent risk factor for adverse 90-day outcomes in patients with cirrhosis and HBV-associated advanced fibrosis. The cutoff values of the AST/ALT ratio could help clinicians monitor the condition of patients when making clinical decisions.
UNASSIGNED: In this study, 3,758 participants (955 with advanced fibrosis and 2,803 with cirrhosis) from the CATCH-LIFE cohort in China were included. The relationships between different AST/ALT ratios and the risk of adverse 90-day outcomes (death or liver transplantation) were determined in patients with cirrhosis or hepatitis B virus (HBV)-associated advanced fibrosis, respectively.
UNASSIGNED: In the patients with HBV-associated advanced fibrosis, the risk of 90-day adverse outcomes increased with AST/ALT ratio; after adjusting for all confounding factors, the risk of adverse 90-day outcomes was the highest when AST/ALT ratio was more than 1.08 (OR = 6.91 [95% CI = 1.789-26.721], p = 0.005), and the AST/ALT ratio of >1.9 accelerated the development of adverse outcomes. In patients with cirrhosis, an AST/ALT ratio > 1.38 increased the risk of adverse 90-day outcomes in all univariables (OR = 1.551 [95% CI = 1.216-1.983], p < 0.001) and multivariable-adjusted analyses (OR = 1.847 [95% CI = 1.361-2.514], p < 0.001), and an elevated AST/ALT ratio (<2.65) accelerated the incidence of 90-day adverse outcomes. An AST/ALT ratio of >1.38 corresponded with a more than 20% incidence of adverse outcomes in patients with cirrhosis.
UNASSIGNED: The AST/ALT ratio is an independent risk factor for adverse 90-day outcomes in patients with cirrhosis and HBV-associated advanced fibrosis. The cutoff values of the AST/ALT ratio could help clinicians monitor the condition of patients when making clinical decisions.
摘要：
■高天冬氨酸转氨酶/丙氨酸转氨酶(AST/ALT)比率与肝病的肝损伤相关；然而，没有关于其与慢性肝病急性加重患者90日预后关系的数据.
■在这项研究中，纳入了来自中国CATCH-LIFE队列的3,758名参与者（955名晚期纤维化患者和2,803名肝硬化患者）。在肝硬化或乙型肝炎病毒（HBV）相关的晚期纤维化患者中，确定了不同的AST/ALT比值与90天不良结局（死亡或肝移植）风险之间的关系，分别。
■在HBV相关晚期纤维化患者中，随着AST/ALT比值的增加，90天不良结局的风险增加；校正所有混杂因素后，当AST/ALT比值大于1.08时，90天不良结局的风险最高（OR=6.91[95％CI=1.789-26.721]，p=0.005),AST/ALT比值>1.9加速了不良结局的发展。在肝硬化患者中，AST/ALT比值>1.38会增加所有单变量90天不良结局的风险（OR=1.551[95％CI=1.216-1.983]，p<0.001)和多变量调整分析(OR=1.847[95%CI=1.361-2.514]，p<0.001)，和升高的AST/ALT比值（<2.65）加速了90天不良结局的发生率。>1.38的AST/ALT比率对应于肝硬化患者的不良结局发生率超过20％。
■AST/ALT比值是肝硬化和HBV相关晚期纤维化患者90天不良结局的独立危险因素。AST/ALT比率的截断值可以帮助临床医生在做出临床决定时监测患者的状况。
■在这项研究中，纳入了来自中国CATCH-LIFE队列的3,758名参与者（955名晚期纤维化患者和2,803名肝硬化患者）。在肝硬化或乙型肝炎病毒（HBV）相关的晚期纤维化患者中，确定了不同的AST/ALT比值与90天不良结局（死亡或肝移植）风险之间的关系，分别。
■在HBV相关晚期纤维化患者中，随着AST/ALT比值的增加，90天不良结局的风险增加；校正所有混杂因素后，当AST/ALT比值大于1.08时，90天不良结局的风险最高（OR=6.91[95％CI=1.789-26.721]，p=0.005),AST/ALT比值>1.9加速了不良结局的发展。在肝硬化患者中，AST/ALT比值>1.38会增加所有单变量90天不良结局的风险（OR=1.551[95％CI=1.216-1.983]，p<0.001)和多变量调整分析(OR=1.847[95%CI=1.361-2.514]，p<0.001)，和升高的AST/ALT比值（<2.65）加速了90天不良结局的发生率。>1.38的AST/ALT比率对应于肝硬化患者的不良结局发生率超过20％。
■AST/ALT比值是肝硬化和HBV相关晚期纤维化患者90天不良结局的独立危险因素。AST/ALT比率的截断值可以帮助临床医生在做出临床决定时监测患者的状况。
