肝纤维化评估在慢性乙型肝炎抗病毒治疗决策和疗效监测中的作用

梁携儿; 陈永鹏

doi:10.3969/j.issn.1001-5256.2016.11.008

肝纤维化评估在慢性乙型肝炎抗病毒治疗决策和疗效监测中的作用

DOI: 10.3969/j.issn.1001-5256.2016.11.008

器官衰竭防治国家重点实验室广东省病毒性肝炎研究重点实验室南方医科大学南方医院感染内科

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中图分类号: R512.62;R575.2
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出版历程
- 出版日期: 2016-11-20

Role of liver fibrosis assessment in decision-making and efficacy surveillance for antiviral therapy in patients with chronic hepatitis B

摘要

摘要:
肝纤维化/肝硬化是慢性乙型肝炎疾病进展的结局,并与肝脏相关事件及远期预后相关;而有效的抗病毒治疗可延缓甚至逆转疾病进展。因此,治疗前及治疗过程中评估肝纤维化程度对启动抗病毒治疗、制订治疗方案以及监测抗病毒疗效和并发症均有重要意义。半定量组织学评分系统是公认的肝纤维化程度评估方法,是乙型肝炎启动抗病毒治疗的重要依据,也是疗效监测的普遍手段,而形态学和结构学全定量方法可提供更客观的组织学肝纤维化评估,可望弥补传统半定量评分的主观性不足;无创肝纤维化评估方法可减少而不会完全替代肝组织学检查,其作为启动治疗决策的界值尚未达成共识,但可提供更丰富的疗效及远期预后信息。
- 肝炎,乙型,慢性 /
- 肝硬化 /
- 活组织检查 /
- 治疗结果
Abstract:
Liver fibrosis / cirrhosis is the outcome of the progression of chronic hepatitis B and is associated with liver events and long- term prognosis. Effective antiviral therapy can delay or even reverse disease progression. Therefore,assessment of liver fibrosis degree before and during treatment is of great importance in initiating antiviral therapy,developing therapeutic regimens,and monitoring antiviral effects and complications. The semi- quantitative histological scoring system is widely acknowledged in the assessment of liver fibrosis degree and is an important basis for the initiation of antiviral therapy for hepatitis B,as well as a method commonly used for efficacy surveillance. Morphological and structural quantitative methods provide objective histological assessment of liver fibrosis and may cover the shortage of conventional semi- quantitative scoring system. Non- invasive methods for the assessment of liver fibrosis may reduce but not completely substitute liver histological examinations; a consensus has not been reached on their cut- off values to make decisions to initiate antiviral therapy,but such non- invasive methods can provide rich information on therapeutic effect and long- term prognosis.
- hepatitis B,chronic /
- liver cirrhosis /
- biopsy /
- treatment outcome

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参考文献(29)

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