由瞬时弹性测量的肝脏僵硬的动态变化预测慢性乙型肝炎患

StephenW

J Ultrasound Med. 2016 Dec 3. doi: 10.7863/ultra.15.12054. [Epub ahead of print]
Dynamic Changes in Liver Stiffness Measured by Transient Elastography Predict Clinical Outcomes Among Patients With Chronic Hepatitis B.Zeng J1, Cai S1, Liu J1, Xue X1, Wu X1, Zheng C1.
Author information

• 1Department of Infectious Diseases, First Affiliated Hospital of Xiamen University, Fujian, China.
  

AbstractOBJECTIVES: We aimed to evaluate the validity of transient elastography in monitoring the antiviral outcomes in patients with chronic hepatitis B.
METHODS: This study included 108 patients treated with nucleos(t)ide analogues and 67 patients treated with interferon (IFN). Liver biopsies were evaluated by the METAVIR score. Transient elastography was performed initially at baseline, 48 weeks, and 96 weeks. Liver tissue was obtained before and after 96 weeks of treatment. The area under the receiver operating characteristic curve was used to examine the diagnostic value of transient elastography in predicting and monitoring outcomes of antiviral treatment.
RESULTS: The liver stiffness value correlated well with the baseline alanine aminotransferase level (r = 0.33; P < .001) and was significantly different among various stages of liver fibrosis (P < .001). In the nucleos(t)ide analogue group, the mean pretreatment and posttreatment liver stiffness values ± SD were 8.7 ± 3.1 and 5.9 ± 1.6 kPa, respectively (P < .001), and they were 9.2 ± 3.7 and 7.2 ± 1.9 kPa (P < .001) in the IFN group. Although the liver stiffness values at baseline between the groups were similar (P = .45), they were 5.9 ± 1.6 kPa in the nucleos(t)ide analogue group and 7.2 ± 1.9 kPa in the IFN group after 48 weeks of treatment (P < .001). With the decreased magnitude liver stiffness for predicting the improvement in liver fibrosis, the area under the receiver operating characteristic curve was 0.68 (P = .029). When the decreased magnitude of liver stiffness was 4.1 kPa or higher, the sensitivity and specificity for predicting a histologic response were 88.2% and 50.0%.
CONCLUSIONS: Our findings suggest that transient elastography is an effective measurement tool for diagnosing and monitoring the histologic response in patients with chronic hepatitis B during antiviral treatment and can help avoid multiple liver biopsies.

© 2016 by the American Institute of Ultrasound in Medicine.

KEYWORDS: METAVIR; gastrointestinal ultrasound; hepatitis B; histologic response; liver fibrosis; transient elastography

PMID:27914175DOI:10.7863/ultra.15.12054

StephenW

J Ultrasound Med。 2016 12月3. doi：10.7863 / ultra.15.12054。 [打印前的电子版]
由瞬时弹性测量的肝脏僵硬的动态变化预测慢性乙型肝炎患者的临床结果
Zeng J1，Cai S1，Liu J1，Xue X1，Wu X1，Zheng C1。
作者信息

1厦门大学第一附属医院传染病科，福建。

抽象
目标：

我们的目的是评估临床弹性成像监测慢性乙型肝炎患者抗病毒结果的有效性。
方法：

该研究包括用核苷（t）ide类似物治疗的108名患者和用干扰素（IFN）治疗的67名患者。通过METAVIR评分评价肝活检。最初在基线，48周和96周进行瞬时弹性成像。在96周治疗前后获得。受试者工作特征曲线下的面积用于检查瞬时弹性成像在预测和监测抗病毒治疗结果的诊断价值。
结果：

肝硬度值与基线丙氨酸氨基转移酶水平（r = 0.33; P <0.001）很好相关，并且在肝纤维化的各个阶段之间显着不同（P <0.001）。在核（t）ide类似物组中，平均预处理和治疗后的肝硬度值±SD分别为8.7±3.1和5.9±1.6 kPa（P <0.001），分别为9.2±3.7和7.2±1.9 kPa P <0.001）。组间基线肝硬度值相似（P = 0.45），在核苷类似物组中为5.9±1.6kPa，在48周治疗后为7.2±1.9kPa（P < .001）。随着肝硬度的大小预测肝纤维化的改善，受试者工作特征曲线下面积为0.68（P = 0.029）。当肝硬度的大小为4.1 kPa或更高时，预测组织学反应的灵敏度和特异性分别为88.2％和50.0％。
结论：

我们的研究结果表明瞬态弹性成像是诊断和监测慢性乙型肝炎患者抗病毒治疗期间的组织学反应的有效测量工具，可以帮助避免多个肝活检。

©2016美国超声医学研究所。
关键词：

METAVIR;胃肠超声;乙型肝炎;组织学反应;肝纤维化;瞬时弹性成像

PMID：
27914175
DOI：
10.7863 / ultra.15.12054