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Liver elastometry and alcohol withdrawal: Median-term follow-up in a psychiatric unit.
Alcohol ( IF 2.3 ) Pub Date : 2020-07-22 , DOI: 10.1016/j.alcohol.2020.07.007
Paul Carrier 1 , Murielle Girard 2 , Marilyne Debette-Gratien 1 , Natacha Ouedraogo 3 , Véronique Loustaud-Ratti 4 , Philippe Nubukpo 5
Affiliation  

The measurement of liver stiffness (LS) shows promise as a follow-up tool after alcohol withdrawal, but it has mainly been studied in the early phase or in patients with severe liver disease. A 6-month ancillary study of a specific psychiatric cohort of alcoholic patients without known liver disease followed after withdrawal was conducted (Clinical Trial NCT01491347). Clinical and biological data and LS values were collected every 2 months. A total of 129 patients were included in the study; 93 had an LS assessment within the first 7 days, and 37 had all four LS measurements. Only seven (7.5%) patients had an initial LS > 12.1 kPa, the threshold used to define severe fibrosis. Abstinence was not associated with changes in LS at the various median-term follow-up periods. However, LS of abstinent subjects decreased significantly relative to that of non-abstinent subjects between M0 and M2. CAP™ values were not associated with abstinence.

The systematic median-term follow-up of withdrawn patients does not appear to be contributory. However, LS could help to detect relapse in the first 2 months after withdrawal for subjects treated in a psychiatric hospital for dependence. It thus could serve as a motivation tool. Prospective studies with various and higher baseline LS values are warranted for simultaneous longitudinal assessment, including for very short- and long-term LS after withdrawal.



中文翻译:

肝脏弹性测定和酒精戒断:精神病科的中期随访。

肝脏硬度 (LS) 的测量显示出作为戒酒后随访工具的前景,但它主要在早期或严重肝病患者中进行研究。对戒断后没有已知肝病的酒精患者的特定精神病队列进行了为期 6 个月的辅助研究(临床试验 NCT01491347)。每 2 个月收集一次临床和生物学数据以及 LS 值。该研究共包括 129 名患者;93 人在前 7 天内进行了 LS 评估,37 人进行了所有四次 LS 测量。只有 7 名 (7.5%) 患者的初始 LS > 12.1 kPa,这是用于定义严重纤维化的阈值。在不同的中期随访期间,禁欲与 LS 的变化无关。然而,在 M0 和 M2 之间,禁欲受试者的 LS 相对于非禁欲受试者的 LS 显着降低。CAP™ 值与禁欲无关。

对退出患者的系统中期随访似乎没有贡献。然而,对于在精神病院接受治疗的患者,LS 可以帮助检测在停药后前 2 个月内的复发。因此,它可以作为一种激励工具。具有各种和更高基线 LS 值的前瞻性研究需要同时进行纵向评估,包括停药后的极短期和长期 LS。

更新日期:2020-09-10
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