中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

慢性乙型肝炎患者肝脏硬度值下降趋势与肝纤维化逆转结局的关系

孔媛媛 孙亚朦 周家玲 吴晓宁 马红 欧晓娟 贾继东 尤红

孔媛媛, 孙亚朦, 周家玲, 吴晓宁, 马红, 欧晓娟, 贾继东, 尤红. 慢性乙型肝炎患者肝脏硬度值下降趋势与肝纤维化逆转结局的关系[J]. 临床肝胆病杂志, 2020, 36(2): 314-318. DOI: 10.3969/j.issn.1001-5256.2020.02.016.
引用本文: 孔媛媛, 孙亚朦, 周家玲, 吴晓宁, 马红, 欧晓娟, 贾继东, 尤红. 慢性乙型肝炎患者肝脏硬度值下降趋势与肝纤维化逆转结局的关系[J]. 临床肝胆病杂志, 2020, 36(2): 314-318. DOI: 10.3969/j.issn.1001-5256.2020.02.016.
Kong YuanYuan, Sun YaMeng, Zhou JiaLing, Wu XiaoNing, Ma Hong, Ou XiaoJuan, Jia JiDong, You Hong. Association between the reduction in liver stiffness measurement and the histological outcome of liver fibrosis regression in patients with chronic hepatitis B[J]. J Clin Hepatol, 2020, 36(2): 314-318. DOI: 10.3969/j.issn.1001-5256.2020.02.016.
Citation: Kong YuanYuan, Sun YaMeng, Zhou JiaLing, Wu XiaoNing, Ma Hong, Ou XiaoJuan, Jia JiDong, You Hong. Association between the reduction in liver stiffness measurement and the histological outcome of liver fibrosis regression in patients with chronic hepatitis B[J]. J Clin Hepatol, 2020, 36(2): 314-318. DOI: 10.3969/j.issn.1001-5256.2020.02.016.

慢性乙型肝炎患者肝脏硬度值下降趋势与肝纤维化逆转结局的关系

DOI: 10.3969/j.issn.1001-5256.2020.02.016
基金项目: 

国家科技重大专项课题(2018ZX10302204,2018ZX09201016); 北京市医院管理局消化内科学科协同发展中心消化专项协作创新课题(XXX0104); 

详细信息
  • 中图分类号: R512.62;R575.2

Association between the reduction in liver stiffness measurement and the histological outcome of liver fibrosis regression in patients with chronic hepatitis B

Research funding: 

 

  • 摘要:

    目的分析抗病毒治疗中慢性乙型肝炎患者肝脏硬度值变化趋势与肝纤维化逆转结局的相关性。方法基于恩替卡韦初治慢性乙型肝炎患者临床随访队列(2013年7月-2015年9月),检测基线和治疗中每半年HBV DNA水平、肝功能、肝脏硬度值。根据更为严格的标准将治疗前后Ishak评分变化分为3组:确定逆转组,Ishak评分下降≥2;不确定组,Ishak评分下降0~1;进展组,Ishak评分升高> 1。多组间比较采用单因素方差分析。采用分段线性混合模型拟合不同肝纤维化逆转结局的慢性乙型肝炎患者肝脏硬度值下降趋势,斜率的显著性及不同组间斜率的比较采用t检验。结果共纳入239例慢性乙型肝炎患者,恩替卡韦治疗1. 5年后,18例患者(7. 5%)达到肝纤维化组织学确定逆转、196例(82. 0%)为不确定、25例(10. 5%)为进展。开始抗病毒治疗半年内肝脏硬度值下降率:确定逆转组为-36. 3%[95%可信区间(95%CI):-52. 8%~-19. 7%],不确定组为-23. 7%(95%CI:-29. 7%~-17. 8%),进展组为-12. 6%(95%CI:-31. 0%~5. 9%)。在...

     

  • [1] PAROLA M,PINZANI M. Liver fibrosis:Pathophysiology,pathogenetic targets and clinical issues[J]. Mol Aspects Med,2019,65:37-55.
    [2] CASTERA L. Invasive and non-invasive methods for the assessment of fibrosis and disease progression in chronic liver disease[J]. Best Pract Res Clin Gastroenterol,2011,25(2):291-303.
    [3] SANDRIN L,FOURQUET B,HASQUENOPH JM,et al. Transient elastography:A new noninvasive method for assessment of hepatic fibrosis[J]. Ultrasound Med Biol,2003,29(12):1705-1713.
    [4] JIA JD,HOU JL,DING HG,et al. Transient elastography compared to serum markers to predict liver fibrosis in a cohort of Chinese patients with chronic hepatitis B[J]. J Gastroenterol Hepatol,2015,30(4):756-762.
    [5] WONG GL,WONG VW,CHOI PC,et al. On-treatment monitoring of liver fibrosis with transient elastography in chronic hepatitis B patients[J]. Antivir Ther,2011,16(2):165-172.
    [6] CASTERA L. Hepatitis B are non-invasive markers of liver fibrosis reliable?[J]. Liver Int,2014,34(Suppl 1):91-96.
    [7] ISHAK K,BAPTISTA A,BIANCHI L,et al. Histological grading and staging of chronic hepatitis[J]. J Hepatol,1995,22(6):696-699.
    [8] DONG XQ,WU Z,LI J,et al. Declining in liver stiffness cannot indicate fibrosis regression in patients with chronic hepatitis B:A 78-week prospective study[J]. J Gastroenterol Hepatol,2019,34(4):755-763.
    [9] KIM MN,KIM SU,KIM BK,et al. Long-term changes of liver stiffness values assessed using transient elastography in patients with chronic hepatitis B receiving entecavir[J]. Liver Int,2014,34(8):1216-1223.
    [10] LIANG XE,CHEN YP,ZHANG Q,et al. Dynamic evaluation of liver stiffness measurement to improve diagnostic accuracy of liver cirrhosis in patients with chronichepatitis B acute exacerbation[J]. J Viral Hepat,2011,18(12):884-891.
    [11] KONG YY,SUN YM,ZHOU JL,et al. Early steep decline of liver stiffness predicts histological reversal of fibrosis in chronic hepatitis B patients treated with entecavir[J]. J Viral Hepat,2019,26(5):576-585.
    [12] BEDOSSA P,DARGRE D,PARADIS V. Sampling variability of liver fibrosis in chronic hepatitis C[J]. Hepatology,2003,38(6):1449-1457.
    [13] MARCELLIN P,GANE E,BUTI M,et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B:A 5-year open-label follow-up study[J].Lancet,2013,381(9865):468-475.
    [14] LIM SG,CHO SW,LEE YC,et al. Changes in liver stiffness measurement during antiviral therapy in patients with chronic hepatitis B[J]. Hepatogastroenterology,2011,58(106):539-545.
    [15] MILLONIG G,REIMANN FM,FRIEDRICH S,et al. Extrahepatic cholestasis increases liver stiffness(Fibroscan)irrespective of fibrosis[J]. Hepatology,2008,48(5):1718-1723.
    [16] KETTANEH A,MARCELLIN P,DOUVIN C,et al. Features associated with success rate and performance of Fibroscan measurements for the diagnosis of cirrhosis in HCV patients:A prospective study of 935 patients[J]. J Hepatol,2007,46(4):628-634.
    [17] CHAN HL,WONG GL,CHOI PC,et al. Alanine aminotransferase-based algorithms of liver stiffness measurement by transient elastography(Fibroscan)for liver fibrosis in chronic hepatitis B[J]. J Viral Hepat,2009,16(1):36-44.
  • 加载中
计量
  • 文章访问数:  1900
  • HTML全文浏览量:  114
  • PDF下载量:  634
  • 被引次数: 0
出版历程
  • 收稿日期:  2019-10-08
  • 出版日期:  2020-02-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回