J Viral Hepat:定量胶原蛋白参数评估慢性乙型肝炎非进展期肝纤维化,诊断性能提高

2017-12-08 MedSci MedSci原创

q-FP可以提高轻度、中度CHB患者纤维化的纵向评估的效率和准确性。

监测纵向非进展期肝纤维化是慢性乙型肝炎(CHB)管理中较为常见的一种情况,然而,目前的评估方法通常缺乏足够的诊断性能。本研究旨在评估定量纤维胶原参数(q-FP)在评估中的诊断效能。

本研究使用的是先前的CHB试验(NCT00962533)数据,其中大部分是轻度到中度的纤维化患者。对存在配对肝组织活检的301例患者,进行连续的检测。其中,139例患者用于建立测试,其余的用于内部验证。基线和治疗后104周肝纤维化程度的改变使用q-FP进行评估,并与Ishak纤维化分期进行比较。

基线、104周分别有70%和90%的Ishak F0-2患者。对受试者的测试表明,在判断纤维化缓解发生率方面,q-FP和Ishak分期之间没有差异(68% vs 67%;差异= 0.7%,p = 1.00)。Q-FP表明,肝纤维化缓解与抗病毒效力终点(OR 3.0, 95%CI 1.4-6.5, p=0.005))独立相关,但Ishak检测未能发现此关联(OR 0.6, 95%CI 0.3-1.3, p=0.24)。此外,q-FP检测表明,基因C型比基因B型,男性比女性,抗病毒治疗后,前者的肝纤维化程度更高些。这些结果在验证对象中得到了证实。此外,建立在测试对象上的功能模型显示,验证主体的纤维性-可逆性在分层上有82%的准确性。

q-FP可以提高轻度、中度CHB患者纤维化的纵向评估的效率和准确性。

原始出处

Wang Y, Liang X, Yang J, et al. Improved performance of quantitative collagen parameters versus standard histology in longitudinal assessment of non-advanced liver fibrosis for chronic hepatitis B. J Viral Hepat, 2017, Nov 29. doi: 10.1111/jvh.12835.

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    2018-05-07 swallow
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    2017-12-10 gwc384
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在entecavir或tenofovir治疗过程中,"治疗ALT升高",特别是增高> 5X ULN,可以增强/加速HBsAg下降,这提示免疫恢复对有效病毒抑制的作用。

Hepatology:酒精消耗与代谢综合征的交互作用,预测一般人群严重肝病

代谢综合征的多个组成部分独立地影响严重肝病的风险。

J Viral Hepat:HBeAg(+)高病毒载量患者,抗病毒治疗期间病毒抑制延迟增加了HCC发生率

当获得完全病毒学抑制的时间超过2年后,无论是否病毒抑制,HCC积累发病率没有显著差异。抗病毒治疗开始的2年内,彻底的乙肝病毒抑制与HCC或肝硬化发生风险的降低相关。

Hepatology:乙型肝炎患者的肝活检显示特定的micro RNA的参与 病毒持续复制和肝细胞损伤等过程

本研究中发现的miRNA特性证实了先前的发现,并为理解HBV相关肝脏疾病提供了新的见解,可能有助于早期疾病诊断和开展有针对性的治疗。