Changes of laboratory variables with time in cirrhosis: prognostic and therapeutic significance.
The time change of laboratory variables in cirrhosis was studied by analysis of data from 488 patients with cirrhosis included in a controlled clinical trial of long-term prednisone vs. placebo. In the placebo group, a marked regression towards normal was seen within 3 months of entry into the trial (increase in serum albumin, acetylcholinesterase, cholesterol, hemoglobin and decrease in erythrocyte sedimentation rate). The subsequent course did not show a clear pattern, except for a slight increase in serum bilirubin and decrease in albumin. When studied in relation to the time of death in patients dying from a "hepatic" cause, marked increase in bilirubin and decrease in prothrombin index, albumin and cholesterol were seen in the year prior to death with little change before that time. In the prednisone group, a more marked decrease in bilirubin, SGOT, alkaline phosphatase, gamma-globulin, sulfobromophthalein retention, erythrocyte sedimentation rate and increase in leukocytes, prothrombin index and cholesterol were seen during the first 3 months. In relation to time of death from a "hepatic" cause, similar changes were seen as in the placebo group except that alkaline phosphatase increased and cholesterol did not decrease. A beneficial effect of prednisone on survival, as expressed by a previously developed therapeutic index, was associated with decrease in SGOT, alkaline phosphatase and gamma-globulin within the first 3 months. An increase in SGOT during prednisone seemed to be associated with harmful effects of therapy.
E
E
Christensen
P
P
Schlichting
L
L
Fauerholdt
E
E
Juhl
H
H
Poulsen
N
N
Tygstrup
D000110:Acetylcholinesterase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002784:Cholesterol / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D011241:Prednisone / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D011517:Prothrombin Time; D012016:Reference Values; D012709:Serum Albumin / Q000032:analysis; D013995:Time; D005719:gamma-Globulins / Q000032:analysis
D006454:Hemoglobins; D012709:Serum Albumin; D005719:gamma-Globulins; D002784:Cholesterol; D000110:Acetylcholinesterase; D000469:Alkaline Phosphatase; D001663:Bilirubin; D011241:Prednisone