Hepatology:乙肝治疗前后肝纤维化评估新分类

2017-03-26 MedSci MedSci原创

背景:纤维生成和纤维溶解动态变化的最终结果是肝脏纤维化。证据表明抗病毒治疗可逆转肝脏纤维化,甚或是HBV导致的早期肝硬化。然而,近期的评估系统主要关注纤维化的严重程度,而非其动态变化。方法:我们提出一种评估纤维化动态变化的新的分类:显着进展(厚/宽/疏松/分隔模糊伴炎症);显着逆转(着色浅/窄/致密/分隔)和表现为改善和退化瘢痕形成总体平衡的中间状态。然后,我们使用该分类评估恩替卡韦治疗前和治疗后

背景:纤维生成和纤维溶解动态变化的最终结果是肝脏纤维化。证据表明抗病毒治疗可逆转肝脏纤维化,甚或是HBV导致的早期肝硬化。然而,近期的评估系统主要关注纤维化的严重程度,而非其动态变化。

方法:我们提出一种评估纤维化动态变化的新的分类:显着进展(厚/宽/疏松/分隔模糊伴炎症);显着逆转(着色浅/窄/致密/分隔)和表现为改善和退化瘢痕形成总体平衡的中间状态。然后,我们使用该分类评估恩替卡韦治疗前和治疗后78周的71例慢性乙型病毒性肝炎患者配对的肝脏活检标本。

结果:进展、中间和逆转的比例在治疗前和治疗后分别为58%、29%、13%和11%、11%、78%。在55例治疗后肝脏活检提示显着改善的患者中,29例患者纤维化至少有一个Ishak分期改善,更为有意义的是,在25例Ishak分期无改善患者在Laennec分期、胶原百分比面积和肝脏硬度方面有明显改善。

结论:新分类强调评估和识别纤维化的动态变化,在抗病毒治疗方面尤为重要。

原始出处:
Yameng Sun,Jialing Zhou,Lin Wang, et al. New classification of liver biopsy assessment for fibrosis in chronic hepatitis B patients before and after treatment. Hepatology,22 March 2017, DOI: 10.1002/hep.29009

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    2017-03-27 gwc384
  3. [GetPortalCommentsPageByObjectIdResponse(id=1808142, encodeId=30cd1808142d5, content=<a href='/topic/show?id=f94d81342e5' target=_blank style='color:#2F92EE;'>#肝纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81342, encryptionId=f94d81342e5, topicName=肝纤维)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Wed May 03 09:58:00 CST 2017, time=2017-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426706, encodeId=07db1426e0607, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Mon Mar 27 15:58:00 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182993, encodeId=0b74182993ca, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77711725691, createdName=doctor_hong, createdTime=Mon Mar 27 08:16:31 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182987, encodeId=ad9418298ebd, content=新分类强调评估和识别纤维化的动态变化,在抗病毒治疗方面尤为重要。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Mar 27 08:12:08 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182851, encodeId=2838182851ad, content=学习了,分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Mar 26 13:15:58 CST 2017, time=2017-03-26, status=1, ipAttribution=)]
    2017-03-27 doctor_hong

    学习了

    0

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    2017-03-27 ylzr123

    新分类强调评估和识别纤维化的动态变化,在抗病毒治疗方面尤为重要。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1808142, encodeId=30cd1808142d5, content=<a href='/topic/show?id=f94d81342e5' target=_blank style='color:#2F92EE;'>#肝纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81342, encryptionId=f94d81342e5, topicName=肝纤维)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Wed May 03 09:58:00 CST 2017, time=2017-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426706, encodeId=07db1426e0607, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Mon Mar 27 15:58:00 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182993, encodeId=0b74182993ca, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77711725691, createdName=doctor_hong, createdTime=Mon Mar 27 08:16:31 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182987, encodeId=ad9418298ebd, content=新分类强调评估和识别纤维化的动态变化,在抗病毒治疗方面尤为重要。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Mar 27 08:12:08 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182851, encodeId=2838182851ad, content=学习了,分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Mar 26 13:15:58 CST 2017, time=2017-03-26, status=1, ipAttribution=)]
    2017-03-26 dhzzm

    学习了,分享了

    0

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