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Validation of the Nanjing Criteria for Diagnosing Pyrrolizidine Alkaloids-induced Hepatic Sinusoidal Obstruction Syndrome

查看全文 作　　者：Wei [1]Zhang;Lu [1,2]Liu;Ming [1]Zhang;Feng [1]Zhang;Chunyan [1]Peng;Bin [1]Zhang;Jun [3]Chen;Lin [3]Li;Jian [4]He;Jiangqiang [1]Xiao;Yanhong [5]Feng;Xunjiang [6]Wang;Aizhen [6]Xiong;Li [6]Yang;Xiaoping [1]Zou;Yuecheng [7]Yu;Yuzheng [1]Zhuge 高影响力作者 机构地区：[1]Department of Gastroenterology,The Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China;[2]Department of Gastroenterology,The Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing,Jiangsu,China;[3]Department of Pathology,The Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China;[4]Department of Imaging,The Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China;[5]Department of Hepatology,Nanjing Second Hospital,Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China;[6]The Ministry of Education Key Laboratory for Standardization of Chinese Medicines,Institute of Chinese Materia Medica,Shanghai University of Traditional Chinese Medicine,Shanghai,China;[7]Liver Diseases Center of PLA and Department of Infectious Diseases,General Hospital of Eastern Theater Command,and Bayi Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China高影响力机构 出　　处：《Journal of Clinical and Translational Hepatology》索引2021年第9卷第3期,共8页高影响力期刊 基　　金：This study was funded in full by the National Natural Science Foundation of China,with grant numbers 8157040652 and 81900552;the Key Project of Nanjing Health and Technology Development,with grant number ZKX19015。 摘　　要：Background and Aims:Hepatic sinusoidal obstruction syndrome(HSOS)is caused by toxic injury to sinusoidal endothelial cells in the liver.The intake of pyrrolizidine alkaloids(PAs)in some Chinese herbal remedies/plants remains the major etiology for HSOS in China.Recently,new diagnostic criteria for PA-induced HSOS(i.e.PA-HSOS)have been developed;however,the efficacy has not been clinically validated.This study aimed to assess the performance of the Nanjing criteria for PA-HSOS.Methods:Data obtained from consecutive patients in multiple hospitals,which included 86 PA-HSOS patients and 327 patients with other liver diseases,were retrospectively analyzed.Then,the diagnostic performance of the Nanjing criteria and simplified Nanjing criteria were evaluated and validated.The study is registered in www.chictr.org.cn(ID:ChiCTR1900020784).Results:The Nanjing criteria have a sensitivity and specificity of 95.35%and 100%,respectively,while the simplified Nanjing criteria have a sensitivity and specificity of 96.51%and 96.33%,respectively,for the diagnosis of PA-HSOS.Notably,a proportion of patients with Budd-Chiari syndrome(11/49)was misdiagnosed as PA-HSOS on the basis of the simplified Nanjing criteria,and this was mainly due to the overlapping features in the enhanced computed tomography/magnetic resonance imaging examinations.Furthermore,most of these patients(10/11)had occlusion or thrombosis of the hepatic vein,and communicating vessels in the liver were found in 8/11 patients,which were absent in PA-HSOS patients.Conclusions:The Nanjing criteria and simplified Nanjing criteria exhibit excellent performance in diagnosing PA-HSOS.Thus,both could be valuable diagnostic tools in clinical practice. 关 键 词：Drug-induced liver injury Hepatic sinusoidal obstruction syndrome Pyrrolizidine alkaloids Sensitivity SPECIFICITY
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