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慢性丙型肝炎治疗后肝脏硬度明显降低。

Liver Stiffness Is Markedly Decreased After Chronic Hepatitis C Treatment.

机构信息

Departments of Gastroenterology.

Internal Medicine.

出版信息

Ultrasound Q. 2022 Jun 1;38(2):142-148. doi: 10.1097/RUQ.0000000000000572.

Abstract

AIM

The aim of the study was to demonstrate the liver stiffness (LS) change in chronic hepatitis C (CHC) patients obtained by elastography point quantification technique in before and after antiviral treatment (AVT).

MATERIAL AND METHODS

This prospective study included 84 patients diagnosed with CHC who had not previously received treatment for CHC and who had an indication for using direct-acting AVT. Necessary measurements were recorded with noninvasive liver fibrosis (LF) examinations. Posttreatment control of patients was carried out (ombitasvir + paritaprevir + ritonavir) + 3 months after the start of treatment for those treated with dasabuvir and 6 months after the start of treatment for patients treated with sofosbuvir + ribavirin. Liver stiffness changed after AVT is accepted as (Δ-LS), LS before AVT-LS after AVT.

RESULTS

Basal LS was found to decrease significantly after AVT (8.00 ± 2.56 kPa vs 6.95 ± 2.86 kPa, P < 0.05). Similar aspartate aminotransferase-to-platelet ratio index and platelet number fibrosis 4 indices were observed before and after AVT (P > 0.05). It was observed that Δ-LS value after AVT was lower in patients with Child-Pugh class A cirrhosis than patients without cirrhosis (P < 0.05). In the comparison between Δ-LS value after AVT and LF score determined by liver biopsy, it was seen that the greatest Δ-LS value was in patients with fibrosis score of 3. An independent relationship was found between Δ-LS after AVT and LF score determined by biopsy (P < 0.05).

CONCLUSIONS

The LS value determined by the elastography point quantification technique is more effective than other noninvasive laboratory methods in demonstrating the CHC treatment response in clinical practice.

摘要

目的

本研究旨在展示采用瞬时弹性成像点定量技术检测慢性丙型肝炎(CHC)患者抗病毒治疗(AVT)前后肝硬度(LS)的变化。

材料与方法

本前瞻性研究纳入了 84 例未曾接受过 CHC 治疗且有直接作用抗病毒药物治疗适应证的 CHC 患者。采用非侵入性肝纤维化(LF)检查记录必要的测量值。对患者进行治疗后随访(对于接受奥贝他韦+帕利瑞韦+利托那韦治疗的患者,在治疗开始后 3 个月进行;对于接受达卡他韦治疗的患者,在治疗开始后 6 个月进行)。AVT 后 LS 的变化被接受为(Δ-LS),即 AVT 前 LS- AVT 后 LS。

结果

AVT 后 LS 明显降低(8.00 ± 2.56 kPa 比 6.95 ± 2.86 kPa,P < 0.05)。AVT 前后观察到相似的天门冬氨酸氨基转移酶与血小板比值指数和血小板计数纤维化 4 指数(P > 0.05)。观察到 AVT 后 Δ-LS 值在 A 级肝硬化患者中低于无肝硬化患者(P < 0.05)。在 AVT 后 Δ-LS 值与肝活检确定的 LF 评分之间的比较中,发现纤维化评分 3 的患者 Δ-LS 值最大。AVT 后 Δ-LS 与活检确定的 LF 评分之间存在独立关系(P < 0.05)。

结论

采用瞬时弹性成像点定量技术确定的 LS 值在临床实践中比其他非侵入性实验室方法更能有效证明 CHC 的治疗反应。

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