Yo In Ku, Kwon Oh Sang, Park Jin Woong, Lee Jong Joon, Lee Jung Hyun, Won In Sik, Na Sun Young, Jang Pil Kyu, Park Pyung Hwa, Choi Duck Joo, Kim Yun Soo, Kim Ju Hyun
Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea.
Clin Mol Hepatol. 2015 Mar;21(1):32-40. doi: 10.3350/cmh.2015.21.1.32. Epub 2015 Mar 25.
BACKGROUND/AIMS: Liver stiffness (LS) as assessed by transient elastography (TE) can change longitudinally in patients with chronic hepatitis B (CHB). The aim of this study was to identify the factors that improve LS.
Between April 2007 and December 2012, 151 patients with CHB who underwent two TE procedures with an interval of about 2 years were enrolled. Ninety-six of the 151 patients were treated with nucleos(t)ide analogues [the antiviral therapy (+) group], while the remaining 55 patients were not [the antiviral therapy (-) group]. The two groups of patients were stratified according to whether they exhibited an improvement or a deterioration in LS during the study period (defined as an LS change of ≤0 or >0 kPa, respectively, over a 1-year period), and their data were compared.
No differences were observed between the antiviral therapy (+) and (-) groups with respect to either their clinical characteristics or their initial LS. The observed LS improvement was significantly greater in the antiviral therapy (+) group than in the antiviral therapy (-) group (-3.0 vs. 0.98 kPa, P=0.011). In the antiviral therapy (+) group, the initial LS was higher in the LS improvement group (n=63) than in the LS deterioration group (n=33; 7.9 vs. 4.8 kPa, P<0.001). However, there were no differences in any other clinical characteristic. In the antiviral therapy (-) group, the initial LS was also higher in the LS improvement group (n=29) than in the LS deterioration group (n=26; 8.3 vs. 6.5 kPa, P=0.021), with no differences in any other clinical characteristic.
A higher initial LS was the only factor associated with LS improvement in patients with CHB in this study.
背景/目的：通过瞬时弹性成像（TE）评估的肝硬度（LS）在慢性乙型肝炎（CHB）患者中可发生纵向变化。本研究的目的是确定能改善LS的因素。
在2007年4月至2012年12月期间，纳入151例接受了两次间隔约2年的TE检查的CHB患者。151例患者中的96例接受了核苷（酸）类似物治疗[抗病毒治疗（+）组]，而其余55例患者未接受治疗[抗病毒治疗（-）组]。根据患者在研究期间LS是改善还是恶化（分别定义为1年内LS变化≤0或>0 kPa）对两组患者进行分层，并比较他们的数据。
抗病毒治疗（+）组和（-）组在临床特征或初始LS方面均未观察到差异。抗病毒治疗（+）组观察到的LS改善明显大于抗病毒治疗（-）组（-3.0对0.98 kPa，P = 0.011）。在抗病毒治疗（+）组中，LS改善组（n = 63）的初始LS高于LS恶化组（n = 33；7.9对4.8 kPa，P < 0.001）。然而，在任何其他临床特征方面均无差异。在抗病毒治疗（-）组中，LS改善组（n = 29）的初始LS也高于LS恶化组（n = 26；8.3对6.5 kPa, P = 0.021），在任何其他临床特征方面均无差异。
较高的初始LS是本研究中CHB患者LS改善的唯一相关因素。
