FibroScan，APRI和FIB-4在接受3年恩替卡韦治疗的显着肝组织学改

StephenW

Clin Exp Med. 2018 Jan 19. doi: 10.1007/s10238-018-0486-5. [Epub ahead of print]
Changes of FibroScan, APRI, and FIB-4 in chronic hepatitis B patients with significant liver histological changes receiving 3-year entecavir therapy.
Li Q1,2, Chen L3, Zhou Y4.
Author information

1
    Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China. [email protected].
2
    Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, 200040, China. [email protected].
3
    Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China.
4
    Department of Infectious Disease, Ruian People's Hospital, Wenzhou, 310000, Zhejiang, China. [email protected].

Abstract

Noninvasive fibrosis tests have been used widely for evaluation of liver fibrosis in patients with chronic hepatitis B (CHB). We aimed to investigate the influence of antiviral treatment on FibroScan, APRI, and FIB-4 in CHB patients with significant liver histological changes (SLHC) defined as inflammatory grade ≥ A2 and/or fibrosis stage ≥ F2. A total of 104 CHB patients with SLHC at the baseline were included. FibroScan, APRI, and FIB-4 values were compared before and after 3-year entecavir (ETV) treatment. Liver stiffness measurement values decreased significantly after 3-year ETV treatment in cirrhosis group (from 13.6 to 9.6 kPa, p = 0.018), significant fibrosis group (from 8.4 to 5.8 kPa, p = 0.001), and mild fibrosis group (from 5.5 to 4 kPa, p < 0.001). APRI decreased significantly after 3-year ETV treatment in patients with cirrhosis (from 0.80 to 0.25, p < 0.001), patients with significant fibrosis (from 0.54 to 0.24, p < 0.001), and those with mild fibrosis (from 0.35 to 0.23, p < 0.001). FIB-4 decreased significantly after 3-year ETV treatment in patients with cirrhosis (from 1.27 to 0.81, p = 0.007) and significant fibrosis (from 1.12 to 0.78, p < 0.001), while did not decrease significantly in patients with mild fibrosis (from 0.90 to 0.80, p = 0.389). FibroScan, APRI, and FIB-4 values decreased significantly after 3-year ETV treatment in CHB patients, which indicates that these noninvasive fibrosis tests might be useful for monitoring regression of liver fibrosis and assessing treatment efficacy during long-term ETV treatment.
KEYWORDS:

Chronic hepatitis B; Entecavir; FibroScan; Liver fibrosis; Noninvasive tests

PMID:
    29350286
DOI:
    10.1007/s10238-018-0486-5

StephenW

Clin Exp Med。 2018 Jan 19。doi：10.1007 / s10238-018-0486-5。 [电子版提前打印]
FibroScan，APRI和FIB-4在接受3年恩替卡韦治疗的显着肝组织学改变的慢性乙型肝炎患者中的变化。
Li Q1,2，Chen L3，Zhou Y4。
作者信息

1
    复旦大学上海市公共卫生临床中心肝病研究室，上海201508 [email protected]。
2
    复旦大学附属华山医院感染科，上海200040 [email protected]。
3
    复旦大学上海市公共卫生临床中心肝病研究室，上海201508
4
    浙江省温州市瑞安市人民医院传染病研究室，310000 [email protected]。

抽象

无创性纤维化试验已广泛用于评估慢性乙型肝炎（CHB）患者的肝纤维化。我们旨在探讨抗病毒治疗对肝炎组织学改变（SLHC）定义为炎性分级≥A2和/或纤维化分期≥F2的CHB患者中FibroScan，APRI和FIB-4的影响。纳入了104例基线SLHC患者。在3年恩替卡韦（ETV）治疗之前和之后比较FibroScan，APRI和FIB-4值。在肝硬化组（13.6〜9.6kPa，p = 0.018），显着纤维化组（8.4〜5.8kPa，p = 0.001）和轻度纤维化组（5.5〜 4千帕，p <0.001）。肝硬化患者接受3年ETV治疗后，APRI明显下降（从0.80到0.25，p <0.001），纤维化显着（从0.54到0.24，p <0.001），轻度纤维化患者从0.35到0.23， p <0.001）。 FIB-4在肝硬化患者接受3年ETV治疗后显着下降（从1.27到0.81，p = 0.007），纤维化显着（从1.12到0.78，p <0.001），而轻度纤维化患者从0.90到0.80，p = 0.389）。在CHB患者接受3年ETV治疗后，FibroScan，APRI和FIB-4值显着下降，这表明这些非侵入性纤维化测试可能有助于监测肝纤维化的退化和评估长期ETV治疗期间的治疗效果。
关键词：

慢性乙型肝炎;恩替卡韦;肝纤维;肝纤维化;无创检测

结论：
    29350286
DOI：
    10.1007 / s10238-018-0486-5

antiHBVren

看来ETV对肝硬化和纤维化也有改善作用
之前的研究，替诺/TAF 的改善作用比ETV更明显，并且有降低表抗的作用