目的:评估中国戊型肝炎病毒感染与肝衰竭的关联,并探讨其重症化的临床特点及影响因素。方法:检索PubMed、Web of Science、Embase、中国知网(CNKI)、万方等数据库,筛选2012年至2023年间相关文献,通过纳排标准及用纽卡斯尔–渥太华量表...
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目的:评估中国戊型肝炎病毒感染与肝衰竭的关联,并探讨其重症化的临床特点及影响因素。方法:检索PubMed、Web of Science、Embase、中国知网(CNKI)、万方等数据库,筛选2012年至2023年间相关文献,通过纳排标准及用纽卡斯尔–渥太华量表进行文献的筛选及质量评价,并采用RevMan5.4软件进行Meta分析。结果:共纳入21项研究,包含5663例急性戊型肝炎患者,其中853例(15.06%)进展为重症。老年(OR = 2.62, 95% CI = 1.98~3.47)、男性(OR = 2.05, 95% CI = 1.06~3.98)、合并基础肝病即重叠感染(OR = 0.29, 95% CI = 0.21~0.42)、糖尿病(OR = 2.11, 95% CI = 1.42~3.11)的患者更易发生肝衰竭。重叠感染者中,重症化的主要危险因素按照其关联性由强到弱依次为:肝硬化(OR = 5.76, 95% CI = 3.61~9.19)、自身免疫性肝病(OR = 4.01, 95% CI = 1.35~11.92)、HBV感染(OR = 3.95, 95% CI = 2.21~7.04)、脂肪性肝病(OR = 1.13, 95% CI = 0.63~2.03)、酒精性肝病(OR = 1.07, 95% CI = 0.57~2.01)。结论:在中国,老年、男性、重叠感染以及糖尿病等是急性戊型肝炎重症化的主要影响因素。而伴有肝硬化的重叠感染者,重症化的风险显著增加。Objective: To assess the association between Hepatitis E virus infection and hepatic failure in China, as well as to investigate the clinical characteristics and risk factors for severity. Methods: A systematic literature search was conducted across databases including PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wan Fang, focusing on studies published between 2012 and 2023. Studies were selected based on predefined inclusion and exclusion criteria, and the quality of the included studies was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed using RevMan 5.4 software. Results: A total of 21 studies involving 5663 patients with acute HEV infection, among which 853 cases (15.06%) progressed to severe hepatitis. Patients with elderly (OR = 2.62, 95% CI = 1.98~3.47), male (OR = 2.05, 95% CI = 1.06~3.98), underlying liver disease or co-infections (OR = 0.29, 95% CI = 0.21~0.42), and diabetes mellitus (OR = 2.11, 95% CI = 1.42~3.11), are at an increased risk of hepatic failure. For patients with co-infection, the main risk factors for severe progression, ranked from strongest to weakest association, were liver cirrhosis (OR = 5.76, 95% CI = 3.61~9.19), autoimmune liver disease (OR = 4.01, 95% CI = 1.35~11.92), HBV infection (OR = 3.95, 95% CI = 2.21~7.04), fatty liver disea
脂代谢是机体重要代谢之一,肝脏作为脂质合成、储存以及代谢的中心器官,二者相互影响。肿瘤细胞所处的局部环境称为肿瘤微环境,为适应肿瘤微环境而发生的代谢改变称为代谢重编。目前脂代谢与肝癌之间的相关性尚不完全清楚,肝癌脂代谢重编的具体过程亦尚未完全揭示。本文介绍了肝癌发生、发展各阶段脂代谢特点,总结了肝癌脂代谢重编过程的最新发现,旨在探究脂代谢在肝癌发生、发展以及预后中的作用,为肝癌防治提供新的思路与依据。Lipid metabolism is one of the important metabolic processes in the body, and the liver is the central organ for lipid synthesis, storage, and metabolism, with a mutual influence between them. The local environment in which the tumour cells are located is called the tumor microenvironment, and the metabolic changes that occur to adapt to the tumor microenvironment are called metabolic reprogramming. At present, the relationship between lipid metabolism and liver cancer is not completely clear, and the specific process of lipid metabolic reprogramming in liver cancer has not yet been fully elucidated. This review introduces the lipid metabolic characteristics of liver cancer at each stage of its occurrence and development, summarizes the latest findings on the lipid metabolic reprogramming process in liver cancer, and aims to explore the role of lipid metabolism in the occurrence, development, and prognosis of liver cancer, providing new ideas and evidence for the prevention and treatment of liver cancer.
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