治疗性肝纤维化的消退是否反映了无创检查？评估服用有效

StephenW

Niger J Clin Pract. 2020 Feb;23(2):226-231. doi: 10.4103/njcp.njcp_7_19.
Does regression in treatment-induced liver fibrosis reflect noninvasive tests? Assessing treatment results of hepatitis B patients who took potent antiviral drugs for 5 years.
Yalaki S1, Yalcin MS1.
Author information

1
    Department of Gastroenterology, Mersin City Hospital Mersin, Turkey.

Abstract
Background:

Chronic liver disease may be reversed through treatment, and it is crucial to have a definitive diagnosis of liver fibrosis for this treatment. Aims: In this study, we aimed to determine whether regression of liver fibrosis in naive patients undergoing strong antiviral therapy is reflected in noninvasive tests.
Materials and Methods:

We systematically reviewed and monitored medical records of patients with chronic hepatitis B who underwent liver biopsy for patient qualification. We selected patients with a liver fibrosis score of two or more who had not previously received antiviral treatment. We used previously described formulas to compute the indirect indicators of fibrosis for the patients and noted the values of Aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), age-platelet index (API), fibrosis index-based 4 factor (FIB-4), AST-platelet ratio index (APRI), mean platelet volume (MPV) and platelet count (PLT).
Results:

We found a significant difference between the three measurements for APRI, AAR and FIB-4 scores and MPV and PLT distributions in patients who were administered entecavir and tenofovir (Friedman P < 0.05). In the post-hoc binary comparison for both entecavir and tenofovir, we found significant differences between the baseline measurements and the 3rd- and 5th-year measurements in terms of APRI, AAR, FIB-4, MPV, and PLT.
Conclusion:

Liver biopsy is considered the gold standard for the treatment and follow-up of hepatitis B but may not be appropriate in all cases. Non-invasive tests may be effective in monitoring antiviral therapy. We demonstrated that non-invasive tests improved with antiviral therapy, which may be a reflection of treatment-regression in liver histopathology.
KEYWORDS:

Hepatitis B; indirect fibrosis markers; noninvasive tests; regression of hepatic fibrosis

PMID:
    32031098
DOI:
    10.4103/njcp.njcp_7_19

StephenW

尼日尔J临床实践。 2020年2月； 23（2）：226-231。 Doi：10.4103 / njcp.njcp_7_19。
治疗性肝纤维化的消退是否反映了无创检查？评估服用有效抗病毒药物5年的乙肝患者的治疗结果。
Yalaki S1，Yalcin MS1​​。
作者信息

1个
土耳其梅尔辛市梅尔辛市医院消化内科。

抽象
背景：

慢性肝病可以通过治疗来逆转，因此对于这种治疗，必须明确诊断肝纤维化至关重要。目的：在这项研究中，我们旨在确定接受强抗病毒治疗的天真的患者肝纤维化的消退是否反映在无创检测中。
材料和方法：

我们系统地审查和监测了接受肝活检以确认患者资格的慢性乙型肝炎患者的病历。我们选择了肝纤维化评分为两分或以上的患者，这些患者以前没有接受过抗病毒治疗。我们使用先前描述的公式计算患者纤维化的间接指标，并注意到天冬氨酸转氨酶（AST）与丙氨酸转氨酶（ALT）的比率（AAR），年龄-血小板指数（API），基于纤维化指数的值4因子（FIB-4），AST血小板比率指数（APRI），平均血小板体积（MPV）和血小板计数（PLT）。
结果：

我们发现在接受恩替卡韦和替诺福韦治疗的患者中，APRI，AAR和FIB-4得分与MPV和PLT分布的三种测量之间存在显着差异（Friedman P <0.05）。在恩替卡韦和替诺福韦的事后二进制比较中，我们发现基线测量值与第3年和第5年测量值之间在APRI，AAR，FIB-4，MPV和PLT方面存在显着差异。
结论：

肝活检被认为是治疗和追踪乙型肝炎的金标准，但可能并非在所有情况下都适用。非侵入性测试可能有效地监测了抗病毒治疗。我们证明了抗病毒治疗改善了非侵入性测试，这可能反映了肝组织病理学治疗退步。
关键字：

乙型肝炎；间接纤维化标志物；无创测试；肝纤维化消退

PMID：
32031098
DOI：
10.4103 / njcp.njcp_7_19

snowxyxy

  "we aimed to determine whether regression of liver fibrosis in naive patients undergoing strong antiviral therapy is reflected in noninvasive tests."