【摘要】 目的探讨拉米夫定对慢性乙型肝炎(CHB)患者肝脏瞬时弹性值的影响及临床意义。方法回顾性分析了我科30例CHB患者使用拉米夫定治疗24周前后的肝脏瞬时弹性值,同时检测其血清ALT、HBV DNA水平,研究拉米夫定抗病毒疗效与肝脏瞬时弹性值之间的关系。结果 30例CHB患者其初始肝脏瞬时弹性值明显高于正常人群;拉米夫定治疗24周后,30例患者肝脏瞬时弹性值较初始明显下降;随访结束时,HBV DNA阴转患者肝脏瞬时弹性值明显低于HBV DNA阳性患者,但HBV DNA水平与肝脏瞬时弹性值无明显相关性(r=0.401,P=0.138)。结论肝脏瞬时弹性值的下降是抗病毒治疗有效的表现,肝脏瞬时弹性的检测可作为CHB患者治疗的随访指标。更多还原

【Abstract】 Objective To investigate the effects of lamivudine on liver stiffness measurement(LSM) in patients with chronic infection with hepatitis B virus(HBV) and determine its clinical significance.Methods Thirty patients with chronic HBV and 30 healthy(non - HBV infected) controls who presented at our hospital for consultation between March 2011 and March 2012 were selected for inclusion in this retrospective study.These patients had received lamivudine - monotherapy for at least 24 weeks.Data for HBV serology,viral load,routine liver biochemistry,and LSM were recorded.The relationship between HBV DNA levels and LSM was analyzed by Spearman rank correlation test.Results The average LSM of the 30 HBV -infected patients was significantly higher than that of the healthy controls[(10.2±2.3) kPa vs.(4.8±1.7) kPa,P <0.05).Twenty - four weeks of lamivudine treatment significantly reduced the LSM in the HBV - infected patients (vs.baseline).In addition,at week 24 of lamivudine treatment,LSM was markedly higher in HBV - infected patients who remained HBV DNA -positive than in those who tested negative for HBV DNA.However,there was no correlation between LSM and HBV DNA level (r = 0.324,P = 0.478 ).Conclusion Decline in LSM may be a useful predictor of efficacious anti - viral therapy.Moreover,LSM may be an important parameter for follow - up of patients with chronic hepatitis B.更多还原