Hepatol Int. 2010 Aug 4;4(4):673-80. doi: 10.1007/s12072-010-9201-7.
Liver stiffness measurement (LSM) can assess liver fibrosis in patients with chronic hepatitis B (CHB). We evaluated whether LSM can be used to assess changes in liver fibrosis during antiviral treatment using nucleos(t)ide analogs in patients with CHB.
We recruited 41 patients with CHB who had significant liver fibrosis, normal or slightly elevated serum alanine aminotransferase (ALT) levels (≤2 × upper limit of normal), and detectable serum hepatitis B virus DNA before antiviral treatment. Patients in Group 1 (n = 23) and Group 2 (n = 18) underwent follow-up LSM after antiviral treatment for 1 and 2 years, respectively.
The mean age, ALT and LSM value of all patients (34 men and 7 women) before antiviral treatment were 46.6 ± 9.5 years, 40.6 ± 17.2 IU/L and 12.9 ± 8.6 kPa, respectively. Hepatitis B e antigen (HBeAg) was detected in 31 patients (75.6%). Fibrosis stage was F2 in 12 (29.3%), F3 in 6 (14.6%) and F4 in 23 (56.1%) patients. After antiviral treatment, LSM values and DNA positivity decreased significantly as compared to baseline (P = 0.018 and P < 0.001 in Group 1; P = 0.017 and P < 0.001 in Group 2, respectively), whereas ALT levels were unchanged (P = 0.063 in Group 1; P = 0.082 in Group 2).
Our preliminary data suggest that LSM can be used to assess liver fibrosis regression after antiviral treatment using nucleos(t)ide analogs in patients with CHB.
肝脏硬度测量（LSM）可用于评估慢性乙型肝炎（CHB）患者的肝纤维化。我们评估了 LSM 是否可用于评估核苷（酸）类似物抗病毒治疗 CHB 患者的肝纤维化变化。
我们招募了 41 名患有明显肝纤维化、血清丙氨酸氨基转移酶（ALT）水平正常或轻度升高（≤2×正常值上限）且可检测到血清乙型肝炎病毒 DNA 的 CHB 患者。第 1 组（n=23）和第 2 组（n=18）患者分别在抗病毒治疗 1 年和 2 年后进行了 LSM 随访。
所有患者（34 名男性和 7 名女性）在抗病毒治疗前的平均年龄、ALT 和 LSM 值分别为 46.6±9.5 岁、40.6±17.2IU/L 和 12.9±8.6kPa。31 名患者（75.6%）检测到乙型肝炎 e 抗原（HBeAg）。12 名患者（29.3%）为 F2 期纤维化，6 名患者（14.6%）为 F3 期纤维化，23 名患者（56.1%）为 F4 期纤维化。与基线相比，抗病毒治疗后 LSM 值和 DNA 阳性率显著下降（第 1 组 P=0.018 和 P<0.001；第 2 组 P=0.017 和 P<0.001），而 ALT 水平无变化（第 1 组 P=0.063；第 2 组 P=0.082）。
我们的初步数据表明，LSM 可用于评估核苷（酸）类似物抗病毒治疗 CHB 患者的肝纤维化逆转。
