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Dig Dis Sci:慢性乙型肝炎患者晚期肝纤维化与坏死性炎症相关与肝脂肪变性无关

2021-02-16 MedSci原创 MedSci原创

慢性乙型肝炎(CHB)是一个全球性的健康问题,全球约有2.5亿人受到影响,患有CHB的人会发生各种不良后果,例如肝失代偿,肝硬化和肝细胞癌(HCC)。

      慢性乙型肝炎(CHB)是一个全球性的健康问题,全球约有2.5亿人受到影响,患有CHB的人会发生各种不良后果,例如肝失代偿,肝硬化和肝细胞癌(HCC)。据报道,老年人,男性,HBeAg阳性,丙氨酸转氨酶(ALT)水平升高,HBV DNA高度活跃复制,同时感染其他肝炎病毒和定量HBsAg较高是肝病进展的危险因素。肝脂肪变性的(HS)在慢性乙型肝炎患者的患病率从14%上升到76%。据报道,患有代谢综合征(MetS)且与NAFLD密切相关的CHB患者的组织学肝硬化程度更高(38%vs. 11%,p <0.001)。本项研究旨在调查HS和肝纤维化之间的关联,并探讨晚期纤维化的预测因素。

 

 

      研究人员回顾性收集了接受肝活检并全面评估HS,坏死性炎症等级[组织学活动指数(HAI)评分和纤维化分期的CHB患者的临床资料。所有患者均进行逻辑回归分析以确定与晚期肝纤维化相关的因素。

 

 

      在这672名患者中,342名(50.9%)患有HS,267名(39.4%)患有晚期肝纤维化。年龄[比值比(OR)1.026,95%置信区间(CI)1.007-1.046,p  = 0.008],体重指数(BMI,OR 1.091,95%CI 1.026-1.159,p  = 0.005),基因型(C vs B)(OR 2.790,95%CI 1.847–4.214,p  <0.001),血小板(OR 0.986,95%CI 0.982–0.991,p  <0.001)和HAI评分(OR 1.197,95%CI 1.114–1.285,p  <0.001)是多因素Logistic回归分析中晚期肝纤维化的独立因素。HAI评分也是非肝硬化亚群中严重肝纤维化的显着相关因素(OR 1.578,95%CI 1.375–1.810,p <0.001)。在总体/非肝硬化人群中,HS与晚期/重要肝纤维化无关(p  > 0.05)。

 

 

      通过本项研究调查发现临床和病理学特征对CHB患者肝纤维化存在影响。HS可能只是潜在MetS的肝脏表现,与肝纤维化的严重程度无关。HAI代表坏死性炎症是晚期或严重肝纤维化的独立预测因子。

 

 

 

 

原始出处:

Yi-Cheng Chen. Et al. Advanced Liver Fibrosis Is Associated with Necroinflammatory Grade but Not Hepatic Steatosis in Chronic Hepatitis B Patients. Digestive Diseases and Sciences.2021.

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href='/topic/show?id=3d745346316' target=_blank style='color:#2F92EE;'>#慢性乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53463, encryptionId=3d745346316, topicName=慢性乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Thu Feb 18 07:42:30 CST 2021, time=2021-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362999, encodeId=af73136299980, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41432, encryptionId=b723414321c, topicName=坏死)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Thu Feb 18 07:42:30 CST 2021, time=2021-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463748, encodeId=f96b1463e4815, content=<a href='/topic/show?id=7d27381288e' target=_blank style='color:#2F92EE;'>#变性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38128, encryptionId=7d27381288e, topicName=变性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f69f6545041, createdName=huangdf, createdTime=Thu Feb 18 07:42:30 CST 2021, time=2021-02-18, status=1, ipAttribution=)]
    2021-08-06 zhaojie88
  8. 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  9. 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authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Thu Feb 18 07:42:30 CST 2021, time=2021-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463748, encodeId=f96b1463e4815, content=<a href='/topic/show?id=7d27381288e' target=_blank style='color:#2F92EE;'>#变性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38128, encryptionId=7d27381288e, topicName=变性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f69f6545041, createdName=huangdf, createdTime=Thu Feb 18 07:42:30 CST 2021, time=2021-02-18, status=1, ipAttribution=)]
    2021-02-18 millore
  10. 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