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Significant changes in liver stiffness measurements in patients with chronic hep [复制链接]

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发表于 2011-9-14 13:25 |只看该作者 |倒序浏览 |打印
J Viral Hepat. 2011 Jul;18(7):e200-5. doi:
10.1111/j.1365-2893.2010.01428.x. Epub 2011 Jan 7.

Significant changes in liver stiffness measurements in patients with
chronic hepatitis B: 3-year follow-up study.

Fung J, Lai CL, Wong DK, Seto WK, Hung I, Yuen MF.

Source

Department of Medicine, The University of Hong Kong, Queen Mary Hospital,
Hong Kong, China.

Abstract

Summary.  For patients with chronic hepatitis B (CHB) infection, changes
in liver stiffness measurement (LSM) over time are not known. We examined
changes longitudinally in a cohort of patients. Four hundred and twenty-six
patients with CHB underwent transient elastography. Patients were followed
regularly, and repeat elastography was performed at 3 years. Hepatitis
serology, viral load and routine liver biochemistry were monitored. Of the
426 patients, 38 (9%) were hepatitis B e-antigen (HBeAg)-positive, 293
(69%) were HBeAg-negative and 95 (22%) were patients with prior hepatitis B
surface antigen (HBsAg) seroclearance. A total of 110 patients received
oral antiviral therapy. There was a significant decline of LSMs at the
follow-up measurement compared to baseline (6.1 vs 7.8 kPa respectively,
P = 0.002) in treated patients who had elevated alanine aminotransferase
(ALT) at baseline and subsequent normalization after 3 years (normal ALT
limit being 30 U/L for males and 19 U/L for females). In nontreated
patients, only the patients with persistently normal ALT at both time
points had significantly lower LSMs at the follow-up measurement compared
to baseline: 4.9 vs 5.3 kPa, respectively, in patients who remained
positive for HBsAg (P = 0.005) and 5.1 vs 5.4 kPa, respectively, in
patients who had HBsAg seroclearance (P = 0.026). In patients who
remained positive for HBsAg, independent factors associated with a
significant decline in LSM of ≥1 kPa included antiviral therapy
(P = 0.011) and the ALT levels at the follow-up time point
(P = 0.024). Thus, in patients with CHB, a significant decline in LSM
after 3 years was observed in treated patients with ALT normalization and
in untreated patients who had persistently normal ALT. Antiviral therapy
and follow-up ALT levels were independent significant factors associated
with a decline in LSM.

© 2011 Blackwell Publishing Ltd.

PMID: 21692933 [PubMed - in process]

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发表于 2011-9-14 13:28 |只看该作者
谷歌翻译
不是100%准确,仅供参考使用。

在患者的肝脏硬度测量显着变化
慢性乙型肝炎:3年随访研究。


Fung J, Lai CL, Wong DK, Seto WK, Hung I, Yuen MF.


来源

医学系,香港大学玛丽医院,
中国香港。

摘要

摘要慢性乙型肝炎(CHB)患者。感染,改变
肝脏硬度测量(LSM)随着时间的推移,不为人所知。我们研究
在纵向的患者群的变化。四百二十六个
慢性乙型肝炎患者进行瞬时弹性。术后随访
定期和重复弹性成像是在3年执行。肝炎
血清学检测,病毒载量和常规肝功能进行了监测。的
426例患者中,38(9%),乙型肝炎e抗原e抗原(HBeAg)阳性,293
(69%)HBeAg阴性,95(22%)与以前的B型肝炎患者
表面抗原(HBsAg)seroclearance。收到共110例
口服抗病毒药物治疗。有显著下降的LSMS
比较基准(6.1 VS 7.8千帕的后续计量,
P = 0.002)在治疗患者谷丙转氨酶升高
(ALT)在基线和3年后的后续的正常化(ALT正常
限制为30 U /大号为男性和19 U / L)为女性。在非治疗
患者,只有在两个时间的持续ALT正常的患者
点在后续计量LSMS相比显着降低
基线:4.9 VS 5.3千帕,分别在患者谁留,
HBsAg阳性(P = 0.005)和5.1 VS 5.4千帕,分别在
乙肝表面抗原seroclearance的患者(P = 0.026)。患者谁
乙肝表面抗原,与相关的独立因素仍然乐观
≥1千帕的LSM显着下降,包括抗病毒治疗
(P = 0.011),并在后续的时间点ALT水平
(P = 0.024)。因此,在慢性乙型肝炎患者,在LSM的显著下降
3年后观察ALT正常化和治疗的患者
在未经治疗的患者曾持续ALT正常。抗病毒治疗
后续ALT水平独立相关的显著因素
在LSM的下降。

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