https://scholars.lib.ntu.edu.tw/handle/123456789/298703
標題: | Decreasing serum alpha-fetoprotein levels in predicting poor prognosis of acute hepatic failure in patients with chronic hepatitis B | 作者: | Yang S.-S. Cheng K.-S. Lai Y.-C. Wu C.-H. Chen T.-K. Lee C.-L. DING-SHINN CHEN |
關鍵字: | Acute hepatic failure; Alpha-fetoprotein; Hepatic encephalopathy | 公開日期: | 2002 | 卷: | 37 | 期: | 8 | 起(迄)頁: | 626-632 | 來源出版物: | Journal of Gastroenterology | 摘要: | Background. We carried out a study to predict the prognosis of acute hepatic failure in patients with chronic hepatitis B. Methods. We studied 25 consecutive patients with severe acute hepatitis. Severe acute hepatitis was defined as the development of acute hepatitis with a total serum bilirubin level of more than 15 mg/dl, prolonged prothrombin time (PT) of more than 5s, and hepatic encephalopathy (HE). All patients were assessed for King's criteria. Positivity for King's criteria was defined as PT more than 100s, or any three of the following: (age < 10 years or >40 years; cryptogenic or drug-induced hepatitis; jaundice for more than 7 days before the onset of HE; PT > 50 s; and serum bilirubin > 17.5 mg/dl). All but 1 patient had serial serum alpha-fetoprotein (AFP) levels measured every 1-2 weeks. Results. Eleven of 17 patients who died during the study met the King's criteria, whereas none of the surviving patients met the criteria. The sensitivity was 64.7% and the specificity, 100% for King's criteria in predicting a poor prognosis. In 16 of the 17 deceased patients, the AFP levels were reduced while their jaundice increased (sensitivity, 94.1%; specificity, 87.5%). All 17 deceased patients met the King's criteria and/or had reduced AFP levels while their jaundice increased (sensitivity, 100 %; specificity, 87.5%). Conclusions. Our observations suggest that the combined use of follow-up AFP levels and King's criteria is helpful in predicting the poor prognosis of severe acute hepatitis superimposed on chronic hepatitis B. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0036696878&doi=10.1007%2fs005350200099&partnerID=40&md5=3dd93e0f91af8334245aeb23e08f1dec http://scholars.lib.ntu.edu.tw/handle/123456789/298703 |
DOI: | 10.1007/s005350200099 | SDG/關鍵字: | alpha fetoprotein; bilirubin; alpha fetoprotein; bilirubin; hepatitis B(e) antigen; acute hepatitis; adult; age; aged; article; bilirubin blood level; clinical article; controlled study; death; disease severity; female; hepatic encephalopathy; hepatitis B; human; jaundice; liver failure; male; prediction; priority journal; prognosis; prothrombin time; sensitivity and specificity; survival; toxic hepatitis; acute disease; blood; hepatitis B; liver failure; middle aged; mortality; prediction and forecasting; Acute Disease; Adult; alpha-Fetoproteins; Bilirubin; Female; Hepatic Encephalopathy; Hepatitis B e Antigens; Hepatitis B, Chronic; Humans; Liver Failure; Male; Middle Aged; Predictive Value of Tests; Prognosis |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。