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Hepatol Res:HCV患者采用直接抗病毒药物治疗,肝脏功能和身体组成的变化

2018-04-23 MedSci MedSci原创

研究持续测量了HCV感染患者的身体成分,这些患者接受了DAA治疗,研究发现骨骼肌的数量显著增加,与血清Alb水平和/或体重或VFA的减少有关。但这一结果仅仅出现在低骨骼肌质量的患者中。

研究背景和目的:低骨骼肌质量(LSM)的管理是一个非常重要的课题,LSM影响肝脏疾病患者的死亡率。慢性丙型肝炎病毒(HCV)患者,包括肝硬化患者,其体内成分的变化是未被探索的。这些患者接受直接抗病毒治疗。在DAA治疗前后进行身体成分测量和肝功能测试。

研究方法:采用多频段生物电阻抗分析法测定血检、内脏脂肪面积(VFA)和肢体骨骼肌质量。在DAA治疗前的24周,DAA开始治疗时,DAA治疗结束时,DAA治疗结束后的24周,DAA治疗结束的48周分别进行检测。

研究结果:血清白蛋白(Alb)水平在DAA治疗后48周显著增加,LSM患者白蛋白水平增加尤为显著。LSM患者的骨骼肌质量指数(SMI)在DAA治疗后(24周和48周后)显著增加(P < 0.05)。SMI的增加与体重的增加或挥发性脂肪酸(VFA)的减少有关

研究结论:研究持续测量了HCV感染患者的身体成分,这些患者接受了DAA治疗,研究发现骨骼肌的数量显著增加,与血清Alb水平和/或体重或VFA的减少有关。但这一结果仅仅出现在低骨骼肌质量的患者中。

原始出处:

Sugimoto R1, Iwasa M1, Hara N, et al. Changes in liver function and body composition by direct-acting antiviral therapy for hepatitis C virus infection. Hepatol Res. 2018 Apr;48(5):337-344. doi: 10.1111/hepr.12999.

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    2018-04-25 ymljack
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target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Wed Apr 25 13:08:00 CST 2018, time=2018-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1489483, encodeId=548914894832e, content=<a href='/topic/show?id=6f71e24390c' target=_blank style='color:#2F92EE;'>#直接抗病毒药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72439, encryptionId=6f71e24390c, topicName=直接抗病毒药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fe638558169, createdName=crystal0565, createdTime=Wed Apr 25 13:08:00 CST 2018, time=2018-04-25, status=1, ipAttribution=), 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createdTime=Tue Apr 24 02:51:22 CST 2018, time=2018-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=308653, encodeId=b28230865341, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Apr 23 23:24:04 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
    2018-04-25 yahu
  5. 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  6. 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createdTime=Tue Apr 24 02:51:22 CST 2018, time=2018-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=308653, encodeId=b28230865341, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Apr 23 23:24:04 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
    2018-04-25 gwc384
  7. 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  8. 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createdTime=Tue Apr 24 02:51:22 CST 2018, time=2018-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=308653, encodeId=b28230865341, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Apr 23 23:24:04 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
    2018-04-25 飛歌

    学习了很有用不错

    0

  9. 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createdTime=Tue Apr 24 02:51:22 CST 2018, time=2018-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=308653, encodeId=b28230865341, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Apr 23 23:24:04 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
    2018-04-24 changjiu

    学习一下谢谢

    0

  10. 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createdTime=Tue Apr 24 02:51:22 CST 2018, time=2018-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=308653, encodeId=b28230865341, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Apr 23 23:24:04 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
    2018-04-23 1e0f8808m18(暂无匿称)

    学习了.谢谢分享.

    0

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23.8%的PLEN阳性患者,接受DAA治疗后获得HCV清除后,PLNEs消失。研究需要更长的随访时间来阐明这一现象的临床重要性,尤其是与HCC发展风险的关系。

J Hepatol:接受DAA治疗的HCV晚期患者,新发HCC比率不高,可能是先前显微、未发现的肿瘤

大型的、前瞻性、基于人群的研究表明,接受DAAs的晚期丙型肝炎患者中,第一年肝癌的风险并不高,而且可能比未治疗的患者低,并且以后会进一步下降。早期肝癌的出现可能反映了先前存在的、显微的、不可检测的肿瘤。

Liver Int:ombitasvir, paritaprevir/r+dasabuvir+ribavirin治疗HCV基因1b型肝硬化患者的真实疗效和安全性

本研究表明,OBV/PTV/r+DSV+RBV治疗肝硬化患者,具有良好的疗效,SVR为96.6%。与治疗相关的严重不良事件比例为2.9%(61/2070),其中大部分为肝脏功能失代偿(1.9%),与肝功能损害和血小板计数较低相关。

Hepatology:EBR/GZR联合SOF治疗HCV基因3型代偿性肝硬化患者初治和经治患者疗效良好

HCV GT3感染和肝硬化患者表现出较高的疗效。超过12周的治疗是不需要的,而且不论基线RASs如何,直接抗病毒疗效都维持不变。本研究的表明,EBR/GZR联合SOF治疗HCV基因3型代偿性肝硬化患者初治和经治患者疗效良好

J Hepatol:HepCom评分,在启动直接抗病毒治疗后,可以检测出高危人群以及相关的临床事件

HepCom评分是Charlson并发症指数、年龄和肝功能(国际标准化比率、白蛋白和胆红素)的组合,在启动直接抗病毒治疗后,可以检测出一组高危人群,以及相关的临床事件。

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