Prediction of liver-related events using fibroscan in chronic hepatitis B patients showing advanced liver fibrosis.
Prediction of liver-related events using fibroscan in chronic hepatitis B patients showing advanced liver fibrosis.
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DOI：
10.1371/journal.pone.0036676
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Park JY
中科院分区：
文献类型：
--
作者：
Kim SU;Lee JH;Kim DY;Ahn SH;Jung KS;Choi EH;Park YN;Han KH;Chon CY;Park JY
使用瞬时弹性成像（FibroScan®）的肝硬度测量（LSM）可以无创地评估肝纤维化。本研究探讨了LSM是否可以预测慢性B型肝炎（CH B）患者肝组织学晚期肝纤维化的肝脏相关事件（LRE）的发展。2006年3月至2010年4月期间，入组了128例在开始核苷类似物治疗前接受LSM和肝活检（LB）并显示组织学晚期纤维化（≥F3）和高病毒载量[HBV DNA ≥ 2，000 IU/mL]的CHB患者。定期随访所有患者以检测LRE的发展，包括肝脏失代偿（静脉曲张出血、腹水、肝性脑病、自发性细菌性腹膜炎、肝肾综合征）和肝细胞癌（HCC）。患者的平均年龄（72名男性，56名女性）为52.2岁。在中位随访期间[中位27.8（12.6-61.6）个月]，19例（14.8%）患者发生LRE（5例肝失代偿，13例HCC，1例两者兼有）。与年龄一起，多变量分析确定LSM是LRE发展的独立预测因子[P<0.044;风险比（HR），1.038; 95%置信区间（CI），1.002-1.081]。当使用最佳临界值（19 kPa）将研究人群分层为两组时，（61.1%）和特异性（86.2%）从时间依赖的受试者工作特征曲线来看，LSM>19 kPa的患者发生LRE的风险显著高于LSM≤19 kPa的患者（HR，7.176; 95%CI，2.257-22.812; P = 0.001）。LSM可以作为慢性乙型肝炎患者肝纤维化进展的预测指标。
Liver stiffness measurement (LSM) using transient elastography (FibroScan®) can assess liver fibrosis noninvasively. This study investigated whether LSM can predict the development of liver-related events (LREs) in chronic hepatitis B (CHB) patients showing histologically advanced liver fibrosis. Between March 2006 and April 2010, 128 CHB patients with who underwent LSM and liver biopsy (LB) before starting nucleot(s)ide analogues and showed histologically advanced fibrosis (≥F3) with a high viral loads [HBV DNA ≥2,000 IU/mL] were enrolled. All patients were followed regularly to detect LRE development, including hepatic decompensation (variceal bleeding, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome) and hepatocellular carcinoma (HCC). The mean age of the patient (72 men, 56 women) was 52.2 years. During the median follow-up period [median 27.8 (12.6–61.6) months], LREs developed in 19 (14.8%) patients (five with hepatic decompensation, 13 with HCC, one with both). Together with age, multivariate analysis identified LSM as an independent predictor of LRE development [P<0.044; hazard ratio (HR), 1.038; 95% confidence interval (CI), 1.002–1.081]. When the study population was stratified into two groups using the optimal cutoff value (19 kPa), which maximized the sum of sensitivity (61.1%) and specificity (86.2%) from a time-dependent receiver operating characteristic curve, patients with LSM>19 kPa were at significantly greater risk than those with LSM≤19 kPa for LRE development (HR, 7.176; 95% CI, 2.257–22.812; P = 0.001). LSM can be a useful predictor of LRE development in CHB patients showing histologically advanced liver fibrosis.
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影响因子：
120.7
作者：
Chen, CJ;Yang, HI;Iloeje, UH
通讯作者：
Iloeje, UH
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Craxì, A
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158.5
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DIOGUARDI, N
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Beaugrand, Michel
影响因子：
6.6
作者：
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Han, Kwang-Hyub