FibroScan瞬时弹性扫描对恩替卡韦抗病毒疗效的动态观察
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摘要
目的:分析探讨FibroScan瞬时弹性扫描设备对恩替卡韦抗病毒疗效动态观察的临床价值。方法:回顾性选取收治的500例乙型肝炎患者资料,将其中270例乙型肝炎E抗原阳性患者纳入观察组,230例乙型肝炎E抗原阴性患者纳入对照组。采用FibroScan瞬时弹性扫描设备分别检查两组患者在使用恩替卡韦治疗前后的肝脏纤维化病理学以及肝脏弹性值的变化,比较两组患者的谷丙转氨酶恢复情况以及乙肝病毒基因(HBVDNA)变化情况。结果:两组患者在使用恩替卡韦治疗后的肝脏纤维化半定量计分均显著高于治疗前,差异有统计学意义(t=5.348,t=5.642;P<0.05);肝脏弹性值亦均显著低于治疗前,差异有统计学意义(t=5.256,t=5.175;P<0.05)。观察组患者肝脏弹性值与其肝脏纤维化半定量计分值之间存在正相关关系(r=0.876,P<0.05)。观察组患者中有236例患者谷丙转氨酶(ALT)恢复指标为87.41%;对照组患者中有189例患者ALT恢复指标为82.17%,两组比较差异无统计学意义。结论:FibroScan瞬时弹性成像技术能够对患者抗病毒治疗的疗效进行动态观察和评估,并可对患者重复进行无创和快速肝纤维化检测,具有一定的临床应用价值。
Objective: To investigate the clinical value of dynamic observation of FibroScan transient elastography scanning equipment on the antiviral curative efficacy of Entecavir. Methods: 500 patients with hepatitis B were retrospectively selected. And according to the examination results, all patients were divided into two groups:observation group(270 cases who were positive in E antigen) and control group(230 cases who were negative in E antigen). The pathological changes of liver fibrosis and liver elasticity before and after Entecavir treatment of two groups were examined by using the transient elastography scanning device of FibroScan. And the changes of alanine transaminase(ALT) recovery and HBV DNA between the two groups were further compared. Results:The semi-quantitative score of liver fibrosis of observation group and control group post treatment with Entecavir were significantly higher than that before treatment with Entecavir(t=5.348, t=5.642, P<0.05). The liver elastic value of both groups post treatment were significantly lower than that before treatment(t=5.256, t=5.175, P<0.05).And the correlation analysis showed that there was a positive correlation between the elastic value of liver and the semi-quantitative score of hepatic fibrosis in observation groups(r=0. 876, P<0.05). The recovery rate of ALT in observation group was 87.41%(236 cases), while it was 82.17% in control group(189 cases), and the difference of that between two group was no significant. Conclusion: FibroScan transient elastography imaging can dynamically observe and evaluate the curative effect of antiviral therapy for patients, and can repeatedly perform noninvasive and rapid detection of liver fibrosis for patients. It has a certain significance in clinical application.
Objective: To investigate the clinical value of dynamic observation of FibroScan transient elastography scanning equipment on the antiviral curative efficacy of Entecavir. Methods: 500 patients with hepatitis B were retrospectively selected. And according to the examination results, all patients were divided into two groups:observation group(270 cases who were positive in E antigen) and control group(230 cases who were negative in E antigen). The pathological changes of liver fibrosis and liver elasticity before and after Entecavir treatment of two groups were examined by using the transient elastography scanning device of FibroScan. And the changes of alanine transaminase(ALT) recovery and HBV DNA between the two groups were further compared. Results:The semi-quantitative score of liver fibrosis of observation group and control group post treatment with Entecavir were significantly higher than that before treatment with Entecavir(t=5.348, t=5.642, P<0.05). The liver elastic value of both groups post treatment were significantly lower than that before treatment(t=5.256, t=5.175, P<0.05).And the correlation analysis showed that there was a positive correlation between the elastic value of liver and the semi-quantitative score of hepatic fibrosis in observation groups(r=0. 876, P<0.05). The recovery rate of ALT in observation group was 87.41%(236 cases), while it was 82.17% in control group(189 cases), and the difference of that between two group was no significant. Conclusion: FibroScan transient elastography imaging can dynamically observe and evaluate the curative effect of antiviral therapy for patients, and can repeatedly perform noninvasive and rapid detection of liver fibrosis for patients. It has a certain significance in clinical application.
引文
[1]刘洪媛,柳芳,姜廷军,等.瞬时弹性扫描对慢性乙型肝炎抗病毒治疗后肝脏纤维化的评价应用研究[J].中国医学装备,2018,15(1):74-77.
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[3]刘加群,王守云,曹立华,等.肝脏瞬时弹性成像对代偿期肝硬化患者恩替卡韦治疗前后肝纤维化程度的评价[J].山东医药,2017,57(41):47-49.
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[9]张晓梅.复方鳖甲软肝片结合恩替卡韦治疗慢性乙型肝炎肝纤维化的疗效及对患者肝功能的影响[J].肝脏,2018,23(5):424-426.
[10]Rowley MW,Patel A,Zhou W,et al.Immune reconstitution syndrome with initiation of treatment of HBV/HIV co-infection:activity Flare associated with E antigen seroconversion[J].Ann Hepatol,2018,18(1):220-224.
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[12]林小萍,侯卫平,陆军平,等.恩替卡韦联合微生态制剂对乙肝肝硬化患者肝功能及预后的临床研究[J].实用医学杂志,2016,32(6):993-995.
[13]Wong TCL,Fung JYY,Chok KSH,et al.Hepatitis B vaccination in patients receiving oral antiviral therapy without hepatitis B immunoglobulin after liver transplant[J].Transplant Proc,2018,50(10):3681-3688.
[14]刘敏,熊锦华,李杰,等.益气活血通络方联合恩替卡韦治疗慢性乙型肝炎肝纤维化的临床观察[J].中西医结合肝病杂志,2016,26(5):298-299.
[15]袁刚,胡爱荣,胡耀仁,等.恩替卡韦和阿德福韦酯治疗代偿期乙肝肝硬化临床疗效及远期预后[J].中国临床药理学与治疗学,2018,23(2):170-174.
[16]王红霞,辛晓梅,张丽娟,等.瞬时弹性波诊断仪在监测慢性乙型肝炎疾病进展中的应用价值分析[J].中国医学装备,2016,13(7):61-63.
[17]Sandkovsky U,Qiu F,Kalil AC,et al.Riskfactors for the development of cytomegalovirus resistance in solid organ transplantation:a retrospective case-control study[J].Transplant Proc,2018,50(10):3763-3768.
[2]Abdel-Moneim A,Aboud A,Abdel-Gabbar M,et al.Sofosbuvir in combination with ribavirin or simeprevir:real-life study of patients with hepatitis C genotype 4[J].Ann Gastroenterol,2019,32(1):93-98.
[3]刘加群,王守云,曹立华,等.肝脏瞬时弹性成像对代偿期肝硬化患者恩替卡韦治疗前后肝纤维化程度的评价[J].山东医药,2017,57(41):47-49.
[4]González-Aldaco K,Torres-Reyes LA,Ojeda-Granados C,et al.Immunometabolic effect of cholesterol in hepatitis c infection:implications in clinical management and antiviral therapy[J].Ann Hepatol,2018,17(6):908-919.
[5]Tun GSZ,Raza M,Hale MF,et al.Polymerase chain reaction for detection of mucosal cytomegalovirus infection in patients with acute ulcerative colitis[J].Ann Gastroenterol,2019,32(1):81-87.
[6]Kamal AM,Mitru P,Ciobanu AD,et al.Positive and negative predictive factors for treatment response in patients with chronic viral C hepatitis[J].Curr Health SciJ,2017,43(4):318-324.
[7]孙密密,张伟,陈刚,等.肝组织病理学在恩替卡韦治疗慢性乙型肝炎中的预测价值[J].中华医学杂志,2017,97(15):1160-1164.
[8]杨二娜,曹武奎.肝纤维化无创诊断的研究进展[J].临床肝胆病杂志,2017,33(11):170-174.
[9]张晓梅.复方鳖甲软肝片结合恩替卡韦治疗慢性乙型肝炎肝纤维化的疗效及对患者肝功能的影响[J].肝脏,2018,23(5):424-426.
[10]Rowley MW,Patel A,Zhou W,et al.Immune reconstitution syndrome with initiation of treatment of HBV/HIV co-infection:activity Flare associated with E antigen seroconversion[J].Ann Hepatol,2018,18(1):220-224.
[11]Mohammad KG,Idrees MK,Ali T,et al.Posttransplant diabetes mellitus among live-related kidney transplant recipients:sindh institute of urology and transplantation experience[J].Saudi J Kidney Dis Transpl,2018,29(6):1320-1325.
[12]林小萍,侯卫平,陆军平,等.恩替卡韦联合微生态制剂对乙肝肝硬化患者肝功能及预后的临床研究[J].实用医学杂志,2016,32(6):993-995.
[13]Wong TCL,Fung JYY,Chok KSH,et al.Hepatitis B vaccination in patients receiving oral antiviral therapy without hepatitis B immunoglobulin after liver transplant[J].Transplant Proc,2018,50(10):3681-3688.
[14]刘敏,熊锦华,李杰,等.益气活血通络方联合恩替卡韦治疗慢性乙型肝炎肝纤维化的临床观察[J].中西医结合肝病杂志,2016,26(5):298-299.
[15]袁刚,胡爱荣,胡耀仁,等.恩替卡韦和阿德福韦酯治疗代偿期乙肝肝硬化临床疗效及远期预后[J].中国临床药理学与治疗学,2018,23(2):170-174.
[16]王红霞,辛晓梅,张丽娟,等.瞬时弹性波诊断仪在监测慢性乙型肝炎疾病进展中的应用价值分析[J].中国医学装备,2016,13(7):61-63.
[17]Sandkovsky U,Qiu F,Kalil AC,et al.Riskfactors for the development of cytomegalovirus resistance in solid organ transplantation:a retrospective case-control study[J].Transplant Proc,2018,50(10):3763-3768.