摘要
目的探讨FibroScan监测肝硬度值与艾滋病(AIDS)合并慢性丙型病毒性肝炎(CHC)患者肝纤维化程度及抗丙型肝炎病毒(HCV)治疗效果的关系。方法选取广州医科大学附属市八医院60例AIDS合并CHC患者,依据抗HCV治疗3个月后治疗效果分为有应答组(n=50)、无应答组(n=10)。比较两组一般资料、治疗前后肝功能指标[谷草转氨酶(AST)、谷丙转氨酶(ALT)]、白蛋白球蛋白比值(A/G)、肝纤维化指标[Ⅳ型胶原(CⅣ)、Ⅲ型前胶原(CPⅢ)、层黏连蛋白(LN)、透明质酸(HA)]水平、肝硬度值,分析AIDS合并CHC患者治疗前后肝硬度值与肝纤维化指标相关性,探讨AIDS合并CHC患者治疗效果有关影响因素,分析肝硬度值对AIDS合并CHC患者抗HCV效果的预测价值。结果无应答组治疗前、治疗3个月后HCV RNA、AST、ALT与CⅣ、CPⅢ、LN、HA、肝硬度值均高于有应答组,A/G比值低于有应答组,差异有统计学意义(P<0.05)。AIDS合并CHC患者治疗前、治疗3个月后肝硬度值与血清CⅣ、CPⅢ、LN、HA水平均呈正相关(P<0.05)。治疗前HCV RNA、LN、HA、肝硬度值均为AIDS合并CHC患者抗HCV治疗效果的影响因素(P<0.05)。治疗前肝硬度值预测AIDS合并CHC患者抗HCV治疗效果为无应答的曲线下面积(AUC)为0.800,当治疗前肝硬度值取截断值14.46 kPa时,其预测敏感度为80.00%,特异度为72.00%。结论FibroScan监测AIDS合并CHC患者肝硬度值,可在一定程度上反映肝纤维化程度,且能辅助临床预测抗HCV治疗效果。
Objective To explore the relationship between FibroScan monitoring of liver stiffness and the degree of liver fibrosis in patients with acquirid immunodeficiency syndrome(AIDS)complicated with chronic hepatitis C(CHC)and the effect of anti-hepatitis C virus(HCV)therapy.Methods Sixty patients with AIDS and CHC in our hospital were selected and divided into response group(n=50)and non-response group(n=10)based on the treatment effect after 3 months of antiHCV treatment.General data,liver function indexes before and after treatment[aspartate aminotransferase(AST),alanine aminotransferase(ALT)],albumin globulin ratio(A/G),liver fibrosis indexes[collagenⅣ(CⅣ),procollagen typeⅢ(CPⅢ),laminin(LN),hyaluronic acid(HA)]levels and liver stiffness values were compared.The correlation between liver stiffness values and liver fibrosis indicators in patients with AIDS combined with CHC before and after treatment was analyzed.Influencing factors related to the treatment effect of patients,and the predictive value of liver stiffness value on the anti-HCV effect of AIDS patients with CHC were analyzed.Results The values of HCV RNA,AST,ALT and CⅣ,CPⅢ,LN,HA and liver stiffness in the non-response group before treatment and 3 months after treatment were all higher than those of the response group,and the A/G ratio was lower than that of the response group(P<0.05).The liver stiffness values of patients with AIDS combined with CHC before treatment and 3 months after treatment were positively correlated with serum CⅣ,CPⅢ,LN,and HA levels(P<0.05).HCV RNA,LN,HA and liver stiffness values before treatment were all influencing factors of the anti-HCV treatment effect of AIDS patients with CHC(P<0.05).The area under the curve(AUC)for predicting the anti-HCV treatment effect of patients with AIDS and CHC before treatment by liver stiffness was 0.800.When the cut-off value of liver stiffness before treatment was 14.46 kPa,its predictive sensitivity was 80.00%,and the specificity was 72.00%.Conclusion FibroScan monitoring liver stiffness in patients with AIDS combined with CHC could reflect the degree of liver fibrosis to a certain extent,and predict the effect of anti-HCV treatment.
作者
韩斌
刘长珠
张舒眉
李海玲
植剑芳
许飞龙
蔡卫平
凌洲焜
HAN Bin;LIU Chang-zhu;ZHANG Shu-mei;LI Hai-ling;ZHI Jian-fang;XU Fei-long;CAI Wei-ping;LING Zhou⁃kun(Department of Ultrasound,Guangzhou Eighth People's Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510060;Department of Infectious Diseases,Guangzhou Eighth People's Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510060;Department of Radiology,Guangzhou Eighth People's Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510060,China)
出处
《热带医学杂志》
CAS
2021年第8期976-979,1015,共5页
Journal of Tropical Medicine
基金
国家科技部“十三五”重大专项(2017ZX10202101-003)
