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抗病毒治疗对慢性乙型肝炎肝硬化的影响。 [复制链接]

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发表于 2018-1-18 15:59 |只看该作者 |倒序浏览 |打印
Infection. 2018 Jan 15. doi: 10.1007 / s15010-017-1113-1. [Epub ahead of print]
Influence of antiviral therapy on the liver stiffness in chronic HBV hepatitis.
Rinaldi L1, Ascione A2, Messina V3, Rosato V4, Valente G5, Sangiovanni V6, Zampino R4, Marrone A4, Fontanella L4, de Rosa N7, Orabona P8, Buonomo C8, Chirianni A6, Adinolfi LE4, Piai G5.
Author information

1
    Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy. [email protected].
2
    Department of Internal Medicine, Center for Liver Diseases, Ospedale Buon Consiglio Fatebenefratelli, Naples, Italy.
3
    Infectious Diseases C.O. Unit, AORN S. Anna and S. Sebastiano, Caserta, Italy.
4
    Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy.
5
    Department of Medical Sciences, AORN S.Anna e S. Sebastiano, Caserta, Italy.
6
    Department of Infectious Emergencies and Infectious Diseases, Azienda Ospedaliera Dei Colli, Naples, Italy.
7
    Department of Diagnostic Service, Azienda Ospedaliera dei Colli, Naples, Italy.
8
    Department of Service, AORN S. Anna and S. Sebastiano, Caserta, Italy.

Abstract
PURPOSE:

The aim of this study was to evaluate the effects of antiviral therapy on liver stiffness measurement (LSM).
METHODS:

Two hundred HBV patients were enrolled from four hospital centers in southern Italy; median age was 50.7 (25-75) males were 68%; 171 patients underwent to liver biopsy and 200 patients had LSM at baseline and 189 at the end of follow-up The cutoffs of the LSM, related to the fibrosis stages, were as follows: non-advanced fibrosis ≤ 8.1 kPa and advanced fibrosis ≥ 8.2 Kpa.
RESULTS:

The baseline value of LSM was 14.1 kPa for advanced fibrosis / cirrhosis and 6.9 kPa for non-advanced fibrosis. The treated patients (68% received Entecavir and 32% Tenofovir) showed a decrease in liver stiffness measurement of 1.5 kPa (p <0.001) in non-advanced fibrosis and of 6 kPa (p <0.001) in advanced fibrosis / cirrhosis. In the patients not under antiviral treatment, no significant change of the LSM was logistically binary regression model showed that the only independent factor associated with a significant change in the LSM was the liver stiffness value at baseline (odd ratio 2.855; 95% CI 1.456-5.788; (p = 0.007 ).
CONCLUSION:

Long-term antiviral therapy induced a significant reduction of liver stiffness measurement and this result may be related to the reduction of liver fibrosis.
KEYWORDS:

Antiviral therapy; Chronic hepatitis B; Hepatic fibrosis; Liver stiffness; Transient elastography

PMID:
    29335905
DOI:
    10.1007 / s15010-017-1113-1

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发表于 2018-1-18 15:59 |只看该作者
感染。 2018年1月15日,doi:10.1007 / s15010-017-1113-1。 [电子版提前打印]
抗病毒治疗对慢性乙型肝炎肝硬化的影响。
Rinaldi L1,Ascione A2,墨西拿V3,Rosato V4,Valente G5,Sangiovanni V6,Zampino R4,Marrone A4,Fontanella L4,de Rosa N7,Orabona P8,Buonomo C8,Chirianni A6,Adinolfi LE4,Piai G5。
作者信息

1
意大利那不勒斯Miraglia广场医疗,外科,神经病学,代谢和老年科学系“Luigi Vanvitelli”大学。 [email protected]
2
意大利那不勒斯Fatebenefratelli Ospedale Buon Consiglio Fatebenefratelli肝病中心内科。
3
传染病C.O. Unit,AORN S. Anna和S. Sebastiano,意大利卡塞塔。
4
意大利那不勒斯Miraglia广场医疗,外科,神经病学,代谢和老年科学系“Luigi Vanvitelli”大学。

意大利卡塞塔AORN S.Anna和S. Sebastiano医学科学系。
6
意大利那不勒斯Azienda Ospedaliera Dei Colli传染性紧急情况和传染病司。
7
诊断服务部,意大利那不勒斯的Azienda Ospedaliera dei Colli。
8
意大利卡塞塔的AORN S. Anna和S. Sebastiano的服务部。

抽象
目的:

本研究的目的是评估抗病毒治疗对肝硬度测量(LSM)的影响。
方法:

意大利南部的四个医院中心招募了二百名HBV患者;中位年龄为50.7(25-75)岁,男性为68%; 171例患者接受了肝活检,200例患者在基线时有LSM,189例在随访结束时LSM与纤维化分期有关的临界值如下:非进展性纤维化≤8.1 kPa和晚期纤维化≥8.2千帕。
结果:

LSM的基线值为晚期纤维化/肝硬化14.1kPa,非进展性纤维化6.9kPa。接受治疗的患者(68%接受恩替卡韦和32%替诺福韦)在非进展性纤维化中的肝硬度测量值减少1.5kPa(p <0.001),晚期肝纤维化/肝硬化中的肝硬度测量值减少6kPa(p <0.001)。在没有抗病毒治疗的患者中,LSM没有显着变化是逻辑二元回归模型显示与LSM显着变化相关的唯一独立因素是基线处的肝硬度值(奇数比率2.855; 95%CI 1.456- 5.788;(p = 0.007)。
结论:

长期的抗病毒治疗可以显着降低肝硬度,这可能与肝纤维化的减少有关。
关键词:

抗病毒治疗;慢性乙型肝炎;肝纤维化;肝硬化;瞬态弹性成像

结论:
29335905
DOI:
10.1007 / s15010-017-1113-1

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发表于 2018-1-29 23:21 |只看该作者
感谢热心转载。这些资料有参考价值。
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