Natural course of progression of liver fibrosis in Japanese patients with chronic liver disease type C – a study of 527 patients at one establishment
Natural course of progression of liver fibrosis in Japanese patients with chronic liver disease type C – a study of 527 patients at one establishment
复制标题
日本 C 型慢性肝病患者肝纤维化进展的自然过程——一项针对一家机构 527 名患者的研究
DOI：
10.1046/j.1365-2893.2000.00235.x
复制
发表时间：
2000
影响因子：
2.5
通讯作者：
Arakawa
中科院分区：
文献类型：
--
作者：
Matsumura;Moriyama;Goto;Tanaka;Okubo;Arakawa
慢性丙型肝炎感染的患者表现出纤维化逐渐进展为肝硬化和肝细胞癌（HCC）。我们研究了感染不同丙型肝炎病毒（HCV）基因型的日本受试者之间肝纤维化的进展是否存在差异。在527例患者中，我们检查了性别、年龄、输血史、输血日期与肝活检日期或HCC诊断日期之间的间隔、血清丙氨酸氨基转移酶水平、血小板计数或HCV基因型与肝纤维化程度之间的关系，分为四个阶段（F1-F4）。此外，我们比较了每种HCV基因型患者每年肝纤维化进展的平均速率。与纤维化评分较低的患者相比，纤维化评分较高的患者往往年龄较大，血小板计数较低，输血间隔较长。输血后肝纤维化进展的平均速率为每年0.12 ± 0.15期。 然而，在≥ 30岁时接受输血的患者中，肝纤维化进展率为0.19 ± 0.22，而在<30岁时接受输血的患者中，肝纤维化进展率为0.09 ± 0.09。 总之，慢性丙型肝炎是一种进行性疾病，基因型1b，2a和2b患者的肝纤维化进展速度相似。应特别注意年龄≥ 30岁的HCV感染患者，因为这些患者的肝内纤维化进展迅速。
Patients with chronic hepatitis C infection show a gradual progression of fibrosis to liver cirrhosis and hepatocellular carcinoma (HCC). We studied whether the progression of liver fibrosis differed among Japanese subjects who were infected with different hepatitis C virus (HCV) genotypes. In 527 patients we examined whether there was a relationship between gender, age, history of blood transfusion, interval between date of blood transfusion and date of liver biopsy or date of diagnosis of HCC, serum alanine aminotransferase level, platelet count or HCV genotype, with the extent of liver fibrosis, classified into four stages (F1–F4). Moreover, we compared the mean rate of liver fibrosis progression per year in patients with each HCV genotype. Patients who had a higher fibrosis score tended to be older, have a lower platelet count and a longer interval since blood transfusion than those who had a lower fibrosis score. The mean rate of liver fibrosis progression was 0.12 ± 0.15 stages per year after the blood transfusion. However, the progression rate of liver fibrosis in patients who had received a blood transfusion when they were ≥ 30 years of age was 0.19 ± 0.22, while the progression rate of liver fibrosis in the patients who had received a blood transfusion when they were < 30 years was 0.09 ± 0.09. In conclusion, chronic hepatitis C is a progressive disease, and patients with genotype 1b, 2a and 2b have a similar rate of progression of liver fibrosis. Particular attention should be paid to patients who are infected with HCV when ≥ 30 years of age, because intrahepatic fibrosis rapidly progresses in these patients.