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在慢性丙型肝炎患者中,利用血清生化参数在直接作用抗病毒药物治疗前、治疗结束时以及治疗后的第一年和第三年对肝纤维化进行研究。

Investigation of liver fibrosis with serum biochemical parameters before treatment with direct-acting antivirals, at the end of treatment, and in the first and third year after treatment in patients with chronic hepatitis C.

作者信息

Bozkurt Mediha, Zerdali Esra, Pehlivanoğlu Filiz

机构信息

Bitlis Tatvan State Hospital, Turkey.

İstanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

出版信息

Clin Exp Hepatol. 2023 Mar;9(1):21-27. doi: 10.5114/ceh.2023.125917. Epub 2023 Mar 17.

Abstract

AIM OF THE STUDY

In the treatment of chronic hepatitis C, the need for non-invasive methods, other than invasive methods, is increasing for the detection of fibrosis before and after treatment. In our study, we aimed to determine the changes in histological response with post-treatment biochemical scoring in patients treated with direct-acting antivirals.

MATERIAL AND METHODS

Between June 1, 2016, and January 1, 2020, 125 patients followed up with a diagnosis of chronic hepatitis C, who presented to Haseki Training and Research Hospital, were enrolled in the study. Scores of APRI, Fibro Q, Fibrosis-4 (FIB-4) index, Doha score, Fibro alpha, and fibrosis-cirrhosis index were used to evaluate the liver fibrosis of the patients with examinations before treatment, at the end of treatment and at the 12 week, first year, and third year after treatment. The study was conducted as a retrospective observational case series.

RESULTS

One hundred twenty-five patients were enrolled in the study. The mean age was 55.5 ±15.9 years. Patients were divided into two groups according to their baseline FIB-4 values: cirrhotic/noncirrhotic. Seven (5.6%) patients had compensated cirrhosis; there were no decompensated cirrhotic patients. There was a statistically significant decrease in scores of APRI, FIB-4, Fibro Q, and Doha score calculated during the end-of-treatment three-year follow-up period.

CONCLUSIONS

It was shown that serum fibrosis scores, such as APRI, FIB-4, Fibro Q, and Doha score, could be used to detect fibrosis before treatment and to follow histological improvement after treatment with direct-acting antivirals (DAA) in chronic hepatitis C patients.

摘要

研究目的

在慢性丙型肝炎的治疗中,相较于侵入性方法,对于治疗前后纤维化检测的非侵入性方法的需求日益增加。在我们的研究中,我们旨在确定接受直接作用抗病毒药物治疗的患者中,治疗后生化评分与组织学反应的变化。

材料与方法

2016年6月1日至2020年1月1日期间,在哈塞基培训与研究医院就诊且被诊断为慢性丙型肝炎并接受随访的125例患者纳入本研究。使用APRI评分、Fibro Q评分、纤维化-4(FIB-4)指数、多哈评分、Fibro alpha评分和纤维化-肝硬化指数,在治疗前、治疗结束时以及治疗后第12周、第1年和第3年对患者进行检查,以评估肝脏纤维化情况。本研究作为一项回顾性观察病例系列进行。

结果

125例患者纳入本研究。平均年龄为55.5±15.9岁。根据基线FIB-4值将患者分为两组:肝硬化/非肝硬化组。7例(5.6%)患者为代偿期肝硬化;无失代偿期肝硬化患者。在治疗结束后的三年随访期内计算的APRI、FIB-4、Fibro Q和多哈评分有统计学显著下降。

结论

结果表明,血清纤维化评分,如APRI、FIB-4、Fibro Q和多哈评分,可用于检测慢性丙型肝炎患者治疗前的纤维化情况,并跟踪直接作用抗病毒药物(DAA)治疗后组织学改善情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96b6/10090997/5f1882274053/CEH-9-50350-g001.jpg

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