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Cirrhosis a brief study progress report
1. Progress Report(研究进度报告) Apr 2017
Presented by
Dr.Raja Waqar Ali (PG MD)
Mentor ; Prof Dr Mr. Huang,(MD,PhD)
Department of Gastroenterology
Lanzhou University Second Hospital
兰州大学第二医院
2. 消化科基本方向
• General Orientation – Gastroenterology
Department and Endoscopy Center of
Lanzhou university second hospital.
• Common clinical procedures carried out in the
wards .
• MDT or MDD 讨论
9. EPIDEMIOLOGY流行病学
• Cirrhosis is an increasing cause of morbidity and
mortality in more developed countries.
• It is the 14th most common cause of death in developed
countries.
• Fourth in central Europe.
• Cirrhosis is the main indication for 5500 liver transplants
each year in Europe.
(Blachier M et al. The burden of liver disease in Europe: a review of available
epidemiological data. J Hepatol 2013)
10.
11.
12. Introduction介绍。
• Cirrhosis has been seen to be not a single
disease entity, but one that can be sub
classified into distinct clinical prognostic
stages, with 1-year mortality ranging from 1%
to 57% depending on the stage.
D’Amico G et al. Natural history and prognostic indicators of survival in cirrhosis: a
systematic review of 118 studies. J Hepatol 2006
13. Pathophysiology病理生理学
• Histopathologists have proposed that the
histological term cirrhosis should be
substituted by Advanced liver disease, to
underline the dynamic processes and variable
prognosis of the disorder.
Hytiroglou P et al. Beyond “cirrhosis”:a proposal from the
International Liver Pathology Study Group.Am J Clin Pathol 2012
16. Prognostic clinical sub-classification
预后临床分类
• four distinct stages has been proposed with
substantially differing likelihoods of mortality:
stage 1
(compensated with no oesophageal varices) has
anestimated mortality of 1% per year
stages 2
(compensated with varices),
stage 3
(decompensated with ascites),
17. 预后临床分类
• Stage 4
• (decompensated with gastrointestinal bleeding) have
annual mortality rates of 3·4%, 20%, and 57%, respectively.
(D’Amico G et al.Natural history and prognostic indicators of
survival in cirrhosis: a systematic review of 118 studies. J Hepatol 2006)
• Infections and renal failure have been considered as
stage 5, with 67% 1-year mortality.
• Acute decompensating events that lead to organ failure
have mortality of 30%
(Moreau R et al, and the CANONIC Study Investigators of the EASL–CLIF
Consortium. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute
decompensation of cirrhosis. Gastroenterology 2013)