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Liver Transpl:新型尿液检测技术可实现对肝脏移植个体酒精消耗的准确测定

来源:生物谷 2014-05-12 10:50

2014年5月12日 讯 /生物谷BIOON/ --近日,刊登在国际杂志Liver Transplantation上的一篇研究论文中,来自意大利的研究人员通过研究表示,尿乙基葡糖苷酸(uEtG)可以准确检测肝脏移植候选人和受者机体的究竟消耗,这也就表明尿乙基葡糖苷酸和酒精消耗障碍的鉴别试验相结合将可以作为医生对患者进行酒精消耗测定的最佳方法。

酒精性肝病是欧洲和美国常见的肝脏移植原因,有研究预测未来因酒精导致的肝脏移植率将达到49%;实际上医学研究证据显示,相比饮酒节制的患者来讲,移植失败的患者往往存在较低的生存率。

来自帕多瓦大学的教授Paolo Angeli表示,评估酒精消耗对于选择肝脏移植候选者非常关键,而且检测肝脏移植者的酒精饮用情况也非常重要,这将帮助研究者对患者进行早期干预防止移植的失败;当前研究中研究者对121个肝脏移植候选者和受者机体中的uEtG、AUDIT-c、血清中乙醇、尿液中乙醇以及碳水化合物缺失转铁蛋白进行了评估,用以评估个体的饮酒状态,参与者需要提供血液和尿液样本来供研究者检测其机体中的酒精标记物。

研究者检测了31%的参与者的酒精消耗量,发现uEtG是一种检测酒精消耗的较强标记物,而利用uEtG和AUDIT-c结合就可以更为精确地检测个体的酒精消耗。

最后研究人员表示,利用uEtG和AUDIT-c将可以对移植候选者和受者的酒精情况进行更好地监测,这对于肝脏移植者的移植成功率非常关键,也可以防止或者降低移植失败的风险。(生物谷Bioon.com)

Assessment of alcohol consumption in liver transplant candidates and recipients: the best combination among the tools available

Salvatore Piano1, Lucio Marchioro1, Elisabetta Gola1, Silvia Rosi1, Filippo Morando1, Marta Cavallin1, Antonietta Sticca1, Silvano Fasolato1, Giovanni Forza2, Anna Chiara Frigo3, Mario Plebani1, Giacomo Zanus4, Umberto Cillo4, Angelo Gatta1 andPaolo Angeli1,5,*

The detection of alcohol consumption in liver transplant candidates (LTCs) and recipients (LTRs) is required to enable a proper assessment of transplant eligibility and an early management of alcohol relapse, respectively. In this clinical setting, urinary ethyl glucuronide (uEtG), the Alcohol Use Disorders Identification Test for alcohol consumption (AUDIT-c), serum ethanol (sETOH), urinary ethanol (uETOH), carbohydrate-deficient transferrin (CDT), and other indirect markers of alcohol consumption were evaluated and compared prospectively in 121 LTCs and LTRs. Alcohol consumption was defined by a positive AUDIT-c or when it was confirmed by patient history in response to his/her abnormal results. Alcohol consumption was found in 30.6% of patients. uEtG was found to be the strongest marker of alcohol consumption (OR=414.5; p<0.0001) and showed a more accurate prediction rate of alcohol consumption when compared to CDT (area under the ROC=0.94 vs 0.63; p<0.0001) and AUDIT-c (AUROC=0.94 vs 0.73;p<0.0001). The combination of uEtG with AUDIT-c showed a higher accuracy in detecting alcohol consumption when compared to the combination of CDT and AUDIT-c (AUROC=0.98 vs 0.80; p<0.001). Furthermore, uEtG was the most useful marker for detecting alcohol consumption in patients with a negative AUDIT-c. In conclusion, the association of AUDIT-c and uEtG improves the detection of alcohol consumption in LTCs and LTRs. Therefore, they should be used routinely in these patients. Liver Transpl , 2014. © 2014 AASLD.

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