摘要
在肝病的临床研究中开展循证医学可以给临床医师提供临床决策的依据。服用含吡咯里西啶生物碱(pyrrolizidine alkaloids,PAs)的植物导致的肝窦阻塞综合征(hepatic sinusoidal obstruction syndrome,HSOS)的确诊比较困难,即使进行创伤性检查,也易误诊。在循证医学理念指导下通过开展病因学、诊断和预后的研究,结合实验室检查,确定了含PAs的植物是HSOS的病因之一,且PAs的代谢物吡咯与蛋白质的加合物可以作为PAs导致的HSOS的诊断标志物和预后的指标。这些研究经历提示,必须带着临床问题进行研究,在研究的不同方向进行顶层设计,并在研究过程中贯彻循证医学理念和方法,才能提供可靠的结果。
Evidence-based medicine in clinical studies of liver diseases can provide clinicians the evidence for decision making. Hepatic sinusoidal obstruction syndrome （HSOS） caused by plants containing pyrrolizidine alkaloids （PAs） is difficuh to diagnose, and it is easy to be misdiagnosed even with invasive examinations. Under the guidance of the concept of evidence-based medicine, through the study of etiology, diagnosis and prognosis, it is determined that PAs-containing plants are one of the causes of HSOS, and the metabolites of PAs, pyrrole-protein adducts, can be used as diagnostic markers and prognostic indicators of HSOS. These research experiences suggest that researches must start with clinical problems. Alter top-level design in different directions, reliable results can be provided with the concepts and methods of evidence-based medicine.
作者
高虹
王吉耀
GAO Hong;WANG Jiyao(Department of Gastroenterology,Zhongshan Hospital,Fudan University,Evidence-based Medicine Center,Fudan University,Shanghai 200032,China)
出处
《胃肠病学和肝病学杂志》
CAS
2018年第9期979-980,共2页
Chinese Journal of Gastroenterology and Hepatology
关键词
循证
临床研究
肝病
肝窦阻塞综合征
Evidence-based
Clinical study
Liver disease
Hepatic sinusoidal obstruction syndrome
