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Dergiler / Marmara Medical Journal / 2026 / Volume: 32 Issue: 1

Non-alkolik steatohepatite bağlı sirozda komplikasyonların ve mortalitenin değerlendirilmesi

The evaluation of complications and mortality in non-alcoholic steatohepatitis-related cirrhosis

Sezgin Vatansever
Zehra Betül Paköz
Sayfa
—
Yayın Tarihi
2019-01-29
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Yapay Zeka Hızlı Bakış & Çıkarımlar

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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Çalışmaya toplam 185 hasta dahil edildi.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Amaç: Non-alkolik yağlı karaciğer hastalığı (NAYKH) saptanan hastaların %4-8’inde siroz ve %1-5’inde hepatoselüler karsinom (HCC) nedeni ile ölüm görülmektedir.
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Temel Bulgular & Veri:Gereçler ve Yöntemler: Çalışmaya, 2008-2018 yılları arasında kliniğimizde NASH’e bağlı siroz tanısı alan hastalar alındı.
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Sonuç & Katkı:Bulgular: Çalışmaya toplam 185 hasta dahil edildi.
🔬Tür:Research Article
📍Kapsam:2008-2018 · 185 hasta
⚙️Değişkenler:Non-alcoholic steatohepatitis · Cirrhosis · Mortality

Özet

Amaç: Non-alkolik yağlı karaciğer hastalığı (NAYKH) saptanan hastaların %4-8’inde siroz ve %1-5’inde hepatoselüler karsinom (HCC) nedeni ile ölüm görülmektedir. Bu çalışmada amaç, nonalkolik steatohepatit (NASH)’e sekonder siroz gelişen hastalarda, siroza ait komplikasyonlar ve mortalite ile ilişkili faktörlerin belirlenmesidir. Gereçler ve Yöntemler: Çalışmaya, 2008-2018 yılları arasında kliniğimizde NASH’e bağlı siroz tanısı alan hastalar alındı. Diyabeti, obezitesi ya da insülin direnci olan ve diğer siroz nedenleri dışlanan hastalar NASH’e bağlı siroz olarak kabul edildi. Hastalar prospektif olarak kayıt altına alınıp takip edildi, analizler retrospektif olarak yapıldı. Bulgular: Çalışmaya toplam 185 hasta dahil edildi. Sağkalım 1. yılda %94,6 ve 5. yılda %57,0 bulundu. Median sağkalım 5,83 yıl saptandı. HCC’un ortaya çıkması 1. yılda %0,7 ve 5. yılda %9,7 bulundu. Çok değişkenli Cox analizinde yaş (OR 1,12, 95% CI 1,04-1,21; P=0.003), kreatinin (OR 24,4, %95 CI 2,32-257,8; P=0.008) ve ensefalopati (OR 24,49, %95 CI 1.06-19.6; p=0.042) bağımsız prediktörler olarak saptandı. Hastalarda 5. yılda assit gelişimi %46,9, varis kanaması gelişimi %21,9 ve ensefalopati gelişimi %18 saptandı. Sonuç: Non-alkolik steatohepatite sekonder siroz gelişen hastalar HCC, varis kanaması, assit ve ensefalopati gelişimi açısından dikkatli takip edilmelidir.

Abstract

Objectives: Cirrhosis is seen in 4-8% of patients with nonalcoholic fatty liver disease (NAFLD), and death occurs in 1-5% of them due to hepatocellular carcinoma (HCC). The aim of this study was to determine the factors associated with complications and mortality in patients with cirrhosis secondary to non-alcoholic steatohepatitis (NASH). Materials and Methods: The patients with cirrhosis due to NASH diagnosed between 2008 and 2018 in our clinic formed the study population. Patients with diabetes, obesity, or insulin resistance and those with cirrhosis due to other causes were excluded. The patients were enrolled and followed up prospectively. Results: A total of 185 patients were included in the study. The survival was 94.6% at the 1st year and 57.0% at the 5th year. Median survival duration was 5.83 years. The rate of HCC development was 0.7% at the 1st year and 9.7% at the 5th year. In the multivariate Cox analysis, age (OR: 1.12, 95% CI: 1.04-1.21; P = 0.003), creatinine (OR: 24.4, 95% CI: 2.32-257.8; P= 0.008) and encephalopathy (OR: 24.49, 95% CI: 1.06-19.6; p = 0.042) were found as independent predictors of mortality. Development of ascites occurred in 46.9%, variceal bleeding in 21.9% and encephalopathy in 18% of patients at the 5th year. Conclusion: Patients with NASH-related cirrhosis should be carefully monitored for HCC development, variceal bleeding, ascites, and encephalopathy.

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Bu Makaleye Atıf Yap

Vatansever, S., Paköz, Z. B. (2019). Non-alkolik steatohepatite bağlı sirozda komplikasyonların ve mortalitenin değerlendirilmesi. Marmara Medical Journal, Volume: 32 Issue: 1. https://doi.org/10.5472/marumj.476330

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