• Title/Summary/Keyword: 간경변(肝硬變)

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Acute Exacerbation with Severe Jaundice in Chronic Hepatitis B Patient (만성 B형 간질환 환자에서 심한 황달을 동반한 급성 악화)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.483-496
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    • 1997
  • 만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7.%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두 (100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명중 3명(23.1%)에만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되며 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성전환의 동반이 흔한 것으로 나타났다.

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Acute Exacerbation with Severe Jaundice in Chronic Hepatitis B Patients (만성 B형 간질환 환자에서 심한 황달을 동반한 급성 악화)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.329-336
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    • 1997
  • 만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두(100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명 중 3명(23.1%)에서만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되면 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성 전환의 동반이 흔한 것으로 나타났다.

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A Case of Portopulmonary Hypertension Associated with Primary Biliary Cirrhosis (원발성 담관성 간경변과 동반된 문맥폐고혈압 1예)

  • Kim, Se Joong;Lee, Eun Ju;Jung, Ki Hwan;Kang, Eun Hae;Lee, Sung Yong;Lim, Hong Euy;Yim, Hyung Joon;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.421-426
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    • 2007
  • Portopulmonary hypertension (PPHTN) is a clinically and pathophysiologically distinct complication of advanced liver disease. PPHTN is characterized by the development of pulmonary arterial hypertension in association with advanced hepatic disease-related portal hypertension. A characteristic feature of PPHTN is an obstruction to the pulmonary artery flow caused by vasoconstriction, the proliferation of the endothelium and smooth muscle components of the vascular wall, as well as in situ thrombosis. This disorder is commonly underdiagnosed but the clinical implications are significant because it has substantial effects on survival and requires special treatment. We report a case of portopulmonary hypertension in a 53-year-old woman with primary biliary cirrhosis who presented with exertional dyspnea.

Factors influencing Symptom Experience in Patients with Liver Cirrhosis (간경변 환자의 증상경험에 영향을 미치는 요인)

  • Kim, Soo Hyun
    • Korean Journal of Adult Nursing
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    • v.17 no.2
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    • pp.248-258
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    • 2005
  • Purpose: The purpose of this study is to examine the factors influencing symptom experience in patients with liver cirrhosis(LC). Method: A descriptive correlational study design was used. A convenience sample of 129 subjects was recruited from the gastroenterology department at two university hospitals in Seoul, Korea. Symptom experience in LC was measured with the instrument developed by the researcher based on Theory of Unpleasant Symptoms(Lenz et al, 1995) and the Child-Pugh Score, the Korean version of Profile of Mood States, and the Family Support Questionnaire were used to identify the factors influencing symptom experience. Results: The mean score of symptom experience was relatively low(M=41.67, SD= 24.71). Among individual symptoms, fatigue had the highest score in all dimensions. Fatigue, abdominal distension and/or peripheral edema, muscle cramps, dry mouth, and change in appearance were explored as symptoms needing management. In the regression analysis, symptom experience was found to be influenced significantly by anxiety/depression($R^2=.418$, p=.000) and the severity of LC(Child-Pugh Score)($R^2=.125$, p=.000). These variables explained 54.3% of the variance in symptom experience(F=63.607. p=.000). Conclusion: It suggests that nurses need to take into consideration psychological factor as well as physiological factor in symptom management for patients with LC.

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Effects of Ikgukwhan and Ikgukbowhawhan on the Production of Collagen and the Regeneration of Liver Cells Damaged by Bile Duct Ligation and Dimethylnitrosamine (익국환과 익국보화환의 실험적(實驗的) 간경변(肝硬變)에 대(對)한 효과(效果))

  • Bae Cheol-Ho;Kim Sung-Hwan;Kim Kang-San;Kang Byung-Ki
    • Herbal Formula Science
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    • v.6 no.1
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    • pp.119-139
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    • 1998
  • This study was to investigate the protective and effects of Ikgukwhan and Ikgukbowhawhan on the liver cirrhosis or fibrosis induced by prolonged bile duct ligation; a new experimental model for cirrhosis and the intraperitoneal injection of dimethylnitrosamine in the rat. The development of fibrosis or cirrhosis and its inhibition by the two prescriptions were examined by the chemical analysis of AST, ALT, and hydroxyproline. The results obtained were as follows. 1. The increase of serum asparate aminotransferase induced by bile ductligation was inhibited by the administration of Ikgukwhan and Ikgukbowhawn extract. 2. The increase of serum alanine aminotransferase induced by bile duct ligation was inhibited by the administration of Ikgukwhan and Ikgukbowhawhan extract. 3. The increase level of serum AST and ALT induced by the intraperitoneal injection of dimethylnitrosamine was inhibited by the administration of Ikgukwhan and Ikgukbowhawhan extract. 4. The increase level of hydroxyproline volume in the damaged liver tissues in the rat was decreased by the oral administration of Ikgukwhan and Ikgukbowhawhan extract. But there were no significant differences in the inhibition rate between the two experimental groups.

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Analysis of Image for Liver Disease using Blood Test in the Ultrasound Fibroscan (Fibroscan에서의 혈액검사를 이용한 간질환의 영상분석)

  • Lee, Jeong-Hyun;Kim, Dong-Hyun;Kim, Changsoo
    • The Journal of the Korea Contents Association
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    • v.15 no.8
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    • pp.389-396
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    • 2015
  • The liver fibrosis is a disease we often see in clinical medicine, and the persistence and repeatition of inflammation and necrosis of liver cells continue for several years, and it is proceeded to cirrhosis. So decrease of death rate and prevalence rate by complications of cirrhosis and hepatocellular carcinoma is main task of clinical medicine by protection of chronic liver ailment patients from proceeding to cirrhosis and hepatocellular carcinoma. So this study tried to represent the ultrasonic image, blood test, the relationship with liver stiffness of diffuse liver ailment patients as numbers. This study was performed with patients from whom the image was taken by ultrasonic and 141 people who were treated by fibroscan, the basic data for blood test was obtained from the test results at the time when ultrasonic image and liver fibroscan was performed. The statistical analysis was performed by One-way analysis of variance(ANOVA) to verify difference between groups. The value of liver stiffness was increased in the order of normal, chronic liver disease and cirrhosis. As a results, ALT and Albumin have no statistical difference between object groups, and there are statistical differences in the results of ultrasonic decoding at age, AST, ALP, Bilirubin, PLT, PT, and kPa, and they are statistically meaningful(p<0.005). And the value of liver stiffness of chronic liver ailment was presented only as over 12.5kPa in other study, but it was represented as numbers for quantitative diagnosis by presenting average kPa threshold value according to disease in this study. And by presenting relationship of diagnosed results, it is considered that it could be used as first tool to diagnose chronic liver ailment patients according to their disease.

Evaluation of Fibrosis in Liver Cirrhosis by Superparamagnetic Iron Oxide (SPIO)-Enhanced MR Imaging: Does the Radiological Non-Invasive Fibrosis Index Correlate with the Laboratory Non-Invasive Fibrosis Index? (Superparamagnetic Iron Oxide-Enhanced MRI를 이용한 간섬유화의 평가: 영상의학적 비침습적 간섬유화 지표가 AST/혈소판 비와 상관 관계가 있는가?)

  • Kim, Shin-Kee;Lee, Chang-Hee;Kim, Kyeong-Ah;Choi, Jae-Woong;Lee, Jong-Mee;Park, Cheol-Min
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.115-122
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    • 2008
  • Purpose : To evaluate the correlation between the radiological non-invasive hepatic fibrosis index (RNHFI), as determined by SPIO-enhanced MRI, and the laboratory non-invasive hepatic fibrosis index. Materials and Methods : Patients (99 total: 61 men and 38 women; mean age: 58 years) who underwent SPIO-enhanced MRI (1.5T) during 5 years included. These patients were subdivided into a liver cirrhosis group (LCG) and a non-liver cirrhosis group (non-LCG). Using PACS view, we measured the RNHFI (mean standard deviation of hepatic signal intensity (SD), noise-corrected coefficient of variation (CV)) of three ROIs in the liver parenchyma by SPIO-enhanced MRI. The laboratory non-invasive hepatic fibrosis index (AST-platelet ratio index (APRI)) of all patients was calculated from the laboratory data. We compared the RNHFI and APRI of LCG with those of non-LC group using Student's t-test. A bivariate correlation was performed to investigate the relationship between the RNHFI and APRI in the LCG. Results : For the LCG, mean values of SD and CV by SPIO-enhanced MRI were $10.3{\pm}3.7$ and $0.19{\pm}0.08$, respectively. For the non-LCG, mean values of SD and CV were $6.5{\pm}1.6$ and $0.08{\pm}0.05$, respectively. The mean APRI of the LCG and the non- LCG were $2.04{\pm}1.7$ and $0.32{\pm}0.32$, respectively. The RNHFI and APRI were significantly different between both groups (p<0.05). For the LCG, the bivariate correlation between SD and APRI revealed a statistically significant positive correlation (r=0.5, p<0.001). In both groups, there was no statistically significant correlation between CV and APRI. Conclusion: A measurement of SD can be a simple and useful method for the evaluation of hepatic fibrosis.

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Affecting factors of the Drinking Behavior of Liver Cirrhosis Patients The Aspects of Convergence of Drinking Behavior and Disease-related of factors (간경변증 환자 음주행위 관련변인 -음주행위와 질병관련 변인의 융복합 측면-)

  • Seo, Young-Sook;Do, Eun-Su
    • Journal of Digital Convergence
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    • v.13 no.7
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    • pp.249-258
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    • 2015
  • This study was conducted to determine the affecting factors among patients with drinking behavior of liver cirrhosis. Data were collected by questionnaire from 157 patients who were diagnosed with liver cirrhosis at a tertiary hospital located in D-city. Measurements included patients' demographic characteristics, clinical characteristics, disease-related of symptom experience, emotional-factors of anxiety-depression and social-factor of social support. Data were analyzed using t-test, and logistic regression analyses. The incidence rate of drinking behavior was 31.8%. Multivariate analysis revealed that smoking(yes), men, symptom experience, social support and anxiety were more likely to report high level of drinking behavior. Future research should consider managing drinking behavior as an essential component of comprehensive care for patients with liver cirrhosis.

웃음 꽃피우는 협회 - 그래픽 건강 뉴스 - 연말이면 고통 받는 간

  • 한국건강관리협회
    • 건강소식
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    • v.35 no.12
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    • pp.38-39
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    • 2011
  • 간은 우리 몸에 필요한 단백질과 여러 가지 영양소를 만들고 저장하며 건강에 해로운 물질을 해독하는 일을 한다. 이러한 간에 이상이 생기면 간장질환이 발생하게 되며, 간장질환은 급격히 발생하는 A형 간염에서부터 6개월 이상 지속되는 만성간염, 지방간, 간경변, 간암까지 매우 다양하다. 이 중 대표적인 질환으로 지방간을 들 수 있다. 연말 각종 모임이나 회식, 송년회 등 잦은 술자리로 인한 문제는 과음으로 오는 지방간이다. 지방간은 과음으로 인한 알코올성 지방간과 비만, 당뇨, 고지혈증 등으로 인한 비알코올성 지방간이 있다.

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