二维剪切波弹性成像检测直接作用抗病毒药物治疗慢性丙型肝炎患者肝硬度显著下降。
Significant decrease in liver stiffness detected by two dimensional shear-wave elastography after treatment with direct-acting antiviral agents in patients with chronic Hepatitis C.
机构信息
Department of Gastroenterology, Mersin University School of Medicine, Mersin, Turkey.
出版信息
Turk J Gastroenterol. 2020 Feb;31(2):142-147. doi: 10.5152/tjg.2020.19418.
BACKGROUND/AIMS: Two-dimensional shear-wave (2D-SWE) elastography is one of the noninvasive methods for the evaluation of liver fibrosis. The purpose of this study is to investigate the changes in liver stiffness (LS) by employing 2D-SWE as well as its correlation with noninvasive fibrosis markers in patients with chronic hepatitis C (CHC), who are undergoing direct-acting antiviral (DAA) therapy.
MATERIALS AND METHODS
The researchers included all the patients with CHC who are scheduled for DAA treatment in this study. 2D-SWE measurements were performed at baseline, end of treatment (EOT), and 12 weeks after the treatment. According to the latest EFSUMB guidelines, elastography measurements were performed during the ultrasonographic evaluation and recorded in kilopascals (unit). The correlation between biochemical and viral responses, and noninvasive fibrosis scores (FIB-4, AST-to-platelet ratio index (APRI)) was also evaluated.
RESULTS
This study employed 230 patients who underwent treatment with DAAs between September 2016 and September 2017. However, 131 patients were able to complete the study, of which 48 (36.6%) were male and 83 (63.4%) were female. The mean age was 65.0 (±11.18) years. Both EOT and sustained viral response (SVR) had the same rate of 99.2% (130/131). The SWE measurement (mean) values at pretreatment, EOT, and 12 weeks after treatment was 12.92, 10.45, and 9.07 kPa, respectively (p<0.05), whereas the APRI scores were 0.76, 0.39, and 0.30, respectively (p<0.05). Additionally, the FIB-4 scores at pretreatment, EOT, and 12 weeks after treatment were 2.98, 2.43, and 2.03, respectively (p<0.05). The results of liver stiffness measurements (LSM) were similar in all the groups of cirrhotic, noncirrhotic, treatment-experienced, and treatment-naive patients.
CONCLUSION
DAA treatments in the patients with CHC led to almost a complete SVR and a considerable decrease in LS in a short time.
背景/目的：二维剪切波弹性成像（2D-SWE）是评估肝纤维化的非侵入性方法之一。本研究旨在探讨慢性丙型肝炎（CHC）患者接受直接作用抗病毒（DAA）治疗时，2D-SWE 检测肝硬度（LS）的变化及其与无创性纤维化标志物的相关性。
材料和方法
研究纳入了所有计划接受 DAA 治疗的 CHC 患者。在基线、治疗结束（EOT）和治疗后 12 周进行 2D-SWE 测量。根据最新的 EFSUMB 指南，在超声评估期间进行弹性成像测量，并以千帕（单位）记录。还评估了生化和病毒应答与无创纤维化评分（FIB-4、AST 与血小板比值指数（APRI））之间的相关性。
结果
本研究纳入了 2016 年 9 月至 2017 年 9 月期间接受 DAA 治疗的 230 例患者，但只有 131 例患者完成了研究，其中 48 例（36.6%）为男性，83 例（63.4%）为女性。平均年龄为 65.0（±11.18）岁。EOT 和持续病毒应答（SVR）的成功率均为 99.2%（130/131）。治疗前、EOT 和治疗后 12 周的 SWE 测量（平均值）值分别为 12.92、10.45 和 9.07kPa（p<0.05），而 APRI 评分分别为 0.76、0.39 和 0.30（p<0.05）。此外，治疗前、EOT 和治疗后 12 周的 FIB-4 评分分别为 2.98、2.43 和 2.03（p<0.05）。肝硬化、非肝硬化、治疗经验和初治患者的 LSM 结果相似。
结论
CHC 患者接受 DAA 治疗后，几乎可完全获得 SVR，并在短时间内显著降低 LS。
Zotero 插件