瞬时弹性扫描评估替比夫定治疗慢性乙型肝炎患者的疗效  

The effect of transient elastography to evaluate antiviral treatment in patients with chronic hepatitis B

作　　者：马科[1] 丁红方[1] 黄加权[1] 宁琴[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院感染科,湖北武汉430030

出　　处：《胃肠病学和肝病学杂志》2015年第9期1130-1132,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：湖北省自然科学基金项目(2013CFB137)

摘　　要：目的探讨瞬时弹性扫描评估替比夫定治疗慢性乙型肝炎(chronic hepatitis B,CHB)的疗效。方法回顾性分析30例CHB患者,均接受替比夫定治疗52周,观察所有患者抗病毒治疗前后肝脏弹性值(liver stiffness,LS)的变化及生化指标、HBV DNA的情况。按治疗52周患者是否达到持续病毒学应答(sustained virologic response,SVR)分为应答组和应答不佳组,单因素分析影响病毒学应答的因素。结果替比夫定治疗后,患者丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、LS及HBV DNA水平均显著下降。病毒学应答的单因素分析显示,基线ALT和AST较高、治疗24周时HBV DNA降至检测下限以下(HBV DNA<500 copies/ml)、24周时LS较基线下降≥20%是CHB患者抗病毒疗效较好的预测因素。结论肝脏瞬时弹性扫描可作为CHB抗病毒治疗随访检测方法,LS早期快速下降可作为疗效较好的预测因素。Objective To investigate the curative effect of transient elastography to evaluate antiviral treatment in pa-tients with chronic hepatitis B （CHB）. Methods In this retrospective study, 30 patients with CHB treated with Telbi-vudine for 52 weeks were included. The biochemical index, HBV DNA levels and liver stiffness （LS） of these patientswere analyzed. Patients were divided into responses group and poor response group by 52 weeks whether achieved sus- tained virologic response （SVR）. Univariate analysis was made to find preA;ctive factors of the viral response. Results After Telbivudine treatment, alanine aminotransferase （ ALT）, aspartate aminotransferase （ AST）, LS and HBV DNA levels declined significantly. Univariate analysis showed that patients with higher ALT and AST in the baseline, HBV DNA 〈500 copies/ml at 24 weeks, LS in the baseline lower than that at 24 weeks≥20% , would achieve a sustained virological response at 52 weeks. Conclusion Transient elastography can be used as follow-up indicators for CHB anti- viral therapy. LS early rapid decline indicates that patients have better viral response.

关 键 词：瞬时弹性扫描 慢性乙型肝炎 抗病毒治疗 替比夫定 肝纤维化 肝脏弹性值 

分 类 号：R737.9[医药卫生—肿瘤]