Worsening of steatosis is an independent factor of fibrosis progression in untreated patients with chronic hepatitis C and paired liver biopsies
Worsening of steatosis is an independent factor of fibrosis progression in untreated patients with chronic hepatitis C and paired liver biopsies
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DOI：
10.1136/gut.52.2.288
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发表时间：
2003-02-01
期刊：
影响因子：
24.5
通讯作者：
Dhumeaux, D
中科院分区：
文献类型：
--
作者：
Castéra, L;Hézode, C;Dhumeaux, D
背景和目标：脂肪变性是慢性丙型肝炎（CHC）患者常见的组织学发现，已被认为影响肝纤维化进展。本研究的目的是评估CHC患者和配对肝活检的脂肪变性和纤维化的演变之间的关系，两个biopsies.Methods：90 6例患者被选中，根据以下标准：没有治疗，没有肝硬化在初始活检，血清肝炎B表面抗原和人类免疫缺陷病毒抗体阴性。在两次活检中评估了坏死性炎症活动度、纤维化和脂肪变性等级。除了组织学病变，研究的参数包括感染源，感染持续时间，体重指数，酒精摄入量，丙氨酸氨基水平，丙型肝炎病毒基因型和病毒load.Results：两次活检之间的平均间隔为48（32）个月。首次活检时发现54%的患者出现脂肪变性，其中9%为重度脂肪变性。在34%的患者中观察到脂肪变性恶化，50%稳定，16%改善。脂肪变性恶化与肝纤维化进展显著相关（p=0.03）或无（p
Background and aims: Steatosis, a frequent histological finding in patients with chronic hepatitis C (CHC), has been suggested to influence liver fibrosis progression. The aim of the present study was to evaluate in patients with CHC and paired liver biopsies the relationship between the evolution of steatosis and that of fibrosis between the two biopsies.Methods: Ninety six patients were selected according to the following criteria: absence of treatment; absence of cirrhosis at initial biopsy; and serum hepatitis B surface antigen and human immunodeficiency virus antibody negativity. Degrees of necroinflammatory activity, fibrosis, and steatosis grades were assessed in the two biopsies. In addition to histological lesions, parameters studied included the source of infection, duration of infection, body mass index, alcohol intake, alanine amino-levels, hepatitis C virus genotype, and viral load.Results: The mean interval between the two biopsies was 48 (32) months. Steatosis was found in 54% of patients at first biopsy, and was severe in 9%. Worsening of steatosis was observed in 34% of patients, stability in 50%, and improvement in 16%. Worsening of steatosis was significantly associated with hepatic fibrosis progression in patients with (p=0.03) or without (p