J Gastroenterol Hepatol:抗HCV治疗后,5年肝脏硬度的改变

2017-11-28 MedSci MedSci原创

获得可持续病毒学应答后,肝硬硬度数值显著下降,在治疗后的第一年,下降幅度更大,而在1年之后趋于平稳。

研究方法:HCV患者获得可持续病毒学应答(SVR)后,肝脏硬度数值减低,但抗病毒治疗后,长期肝脏硬度变化仍不清楚。本研究旨在评估HCV患者抗病毒治疗后,肝脏硬度改变的程度。

研究方法:回顾153例患者的临床资料。采用Fibroscan检测患者肝脏硬度数值。分别记录基线、治疗结束、治疗后第六个月、每年直到第5年的肝脏硬度数据。

研究结果:70例患者采用以干扰素为基础的治疗方案,83例患者采用直接抗病毒药物进行治疗。基线时,53例患者(34.6%)存在肝硬化。112例患者获得可持续病毒学应答(SVR),41例患者未获得可持续病毒学应答。第五年,获得SVR的患者,肝脏硬度从12.3 kPa (9-17.8)降低到6.6 kPa (5.3-7.4)。治疗后立即观察到肝脏硬度明显下降(治疗结束时为- 2.5 kPa,治疗后6个月为- 3.7 kPa),而从1年后开始,刚度下降的幅度逐渐降低。非应答患者,在治疗结束时,肝脏硬度轻微下降(从19.2 kPa到18.1 kPa),在治疗后的6个月,肝脏硬度反弹到基线水平(19.4 kPa),最终在5年内增加到23.7 kPa(15 - 32.5)。

研究结论:获得可持续病毒学应答后,肝硬硬度数值显著下降,在治疗后的第一年,下降幅度更大,而在1年之后趋于平稳。

原始出处

Facciorusso A, Del PV, Turco A, et al. Long-term liver stiffness assessment in HCV patients undergoing antiviral therapy: Results from a 5-year cohort study. J Gastroenterol Hepatol, 2017, Oct 4. doi: 10.1111/jgh.14008.

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    2018-08-08 许安
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    2017-11-30 ymljack
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    2017-11-30 gwc384

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