J Viral Hepat:采用直接抗病毒药物清除HCV后,肝周淋巴结肿大消失

2018-04-16 MedSci MedSci原创

23.8%的PLEN阳性患者,接受DAA治疗后获得HCV清除后,PLNEs消失。研究需要更长的随访时间来阐明这一现象的临床重要性,尤其是与HCC发展风险的关系。

研究背景:在慢性肝病中,肝周淋巴结肿大(PLNE)与肝细胞癌(HCC)呈负相关;然而,丙型肝炎病毒(HCV)根除后,肝周淋巴结状态的变化尚未得到研究。

研究方法:本研究纳入了472名慢性丙型肝炎患者,采用直接抗病毒药物(DAA)治疗后,这些患者实现了病毒的根除。本研究分析了HCV根除前后,肝周淋巴结的状况是否发生了变化(主要终点)。同时研究还评估了,在HCV清除之前,PLNE与临床表现(例如与肝纤维化或肝细胞损伤)之间的相关性(次要终点)。

研究结果:在DAA治疗前,在472例患者中,共有164例(34.7%)患者出现肝周淋巴结肿大。令人惊讶的是,在丙肝病毒根除后,治疗前164例肝周淋巴结肿大的患者中,39例患者(23.8%)淋巴结肿大消失。PLNE的消失,与治疗前的临床参数无关;也与DAA治疗前后临床参数的变化速率无关。对性别和年龄进行调整后,研究发现基线时PLEN的出现与血清HCV RNA水平较低(P = .03)、较高的AST(P =0.004)和ALT水平显著相关(P <0.001)。

研究结论:23.8%的PLEN阳性患者,接受DAA治疗后获得HCV清除后,PLNEs消失。研究需要更长的随访时间来阐明这一现象的临床重要性,尤其是与HCC发展风险的关系。

原始出处


Hikita H, Sato M, Endo M, et al. Disappearance of perihepatic lymph node enlargement after hepatitis C viral eradication with direct-acting antivirals.J Viral Hepat, 2018, 25(4), 329-334. doi: 10.1111/jvh.12819.

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    2018-04-18 ymljack
  4. 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    2018-04-18 yahu
  5. 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authenticateStatus=null, createdAvatar=null, createdBy=fe638558169, createdName=crystal0565, createdTime=Wed Apr 18 12:54:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=306513, encodeId=45b23065131d, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Apr 17 06:07:51 CST 2018, time=2018-04-17, status=1, ipAttribution=)]
    2018-04-18 sodoo
  6. 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  7. 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    2018-04-18 gwc384
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    2018-04-17 飛歌

    厉害了我的哥

    0

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接受直接抗病毒药物治疗,获得持续病毒学应答(SVR)后对死亡率的影响,目前还没有研究的很清楚。本研究共纳入15059例丙型肝炎晚期肝病患者(FIB-4 >3.25分),评估应用直接抗病毒药物治疗,获得SVR后对全因死亡率和肝细胞癌发生率的影响。