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基于索磷布韦的无干扰素治疗方案后肝脏硬度测量值和纤维化评分的变化

Changes in liver stiffness measurements and fibrosis scores following sofosbuvir based treatment regimens without interferon.

作者信息

Elsharkawy Aisha, Alem Shereen Abdel, Fouad Rabab, El Raziky Maissa, El Akel Wafaa, Abdo Mahmoud, Tantawi Omnia, AbdAllah Mohamed, Bourliere Marc, Esmat Gamal

机构信息

Endemic Medicine and Hepatology Department, Faculty of medicine, Cairo University, Cairo, Egypt.

Medical Research Division, National Research Centre, Giza, Egypt.

出版信息

J Gastroenterol Hepatol. 2017 Sep;32(9):1624-1630. doi: 10.1111/jgh.13758.

Abstract

BACKGROUND AND AIM

Accurate evaluation of the degree of liver fibrosis in patients with chronic liver diseases is crucial, as liver fibrosis is important in order to make therapeutic decisions, determine prognosis of liver disease and to follow-up disease progression. Multiple non-invasive methods have been used successfully in the prediction of fibrosis; however, early changes in non-invasive biomarkers of hepatic fibrosis under effective antiviral therapy are widely unknown. The aim of this study is to evaluate changes of transient elastography values as well as FIB-4 and AST to platelet ratio index (APRI) in patients treated with Sofosbuvir-based treatment regimen.

METHODS

This is a retrospective study including 337 chronic HCV Egyptian patients with genotype 4 mainly. They were treated with Sofosbuvir-based treatment regimen. Transient elastography values were recorded as well as FIB-4 and APRI were calculated at baseline and SVR12.

RESULTS

There was a significant improvement of platelets counts, ALT and AST levels, which in turn cause significant improvement in FIB-4 and APRI scores at SVR12. Liver stiffness measurements were significantly lower in SVR12 (14.8 ± 10.7 vs 11.8 ± 8.8 kPa, P = 0.000). About 77% of responders and 81.1% of cirrhotic patients showed improvement in liver stiffness measurements at SVR12.Univariate and multivariate regression analysis showed that failure to achieve improvement in liver stiffness measurements were significantly associated with relapsers and low baseline liver stiffness measurement.

CONCLUSION

Sofosbuvir-based treatment resulted in a clinically significant improvement in parameters of liver fibrosis.

摘要

背景与目的

准确评估慢性肝病患者的肝纤维化程度至关重要,因为肝纤维化对于做出治疗决策、确定肝病预后以及随访疾病进展都很重要。多种非侵入性方法已成功用于预测纤维化;然而,有效抗病毒治疗下肝纤维化非侵入性生物标志物的早期变化却鲜为人知。本研究的目的是评估接受基于索磷布韦治疗方案的患者瞬时弹性成像值以及FIB-4和AST与血小板比值指数(APRI)的变化。

方法

这是一项回顾性研究,主要纳入了337例基因型4的慢性丙型肝炎埃及患者。他们接受了基于索磷布韦的治疗方案。记录瞬时弹性成像值,并在基线和SVR12时计算FIB-4和APRI。

结果

血小板计数、ALT和AST水平有显著改善,这反过来导致SVR12时FIB-4和APRI评分有显著改善。SVR12时肝脏硬度测量值显著更低(14.8±10.7 vs 11.8±8.8 kPa,P = 0.000)。约77%的应答者和81.1%的肝硬化患者在SVR12时肝脏硬度测量值有所改善。单因素和多因素回归分析表明,肝脏硬度测量值未实现改善与复发者以及低基线肝脏硬度测量值显著相关。

结论

基于索磷布韦的治疗使肝纤维化参数出现了具有临床意义的改善。

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