Noninvasive assessment of liver fibrosis with combined serum aminotransferase/platelet ratio index and hyaluronic acid in patients with chronic hepatitis B

AIM： To construct a noninvasive assessment model consisting of routine laboratory data to predict significant fibrosis and cirrhosis in patients with chronic hepatitis B （CHB）. METHODS： A total of 137 consecutive patients with CriB who underwent percutaneous liver biopsy were retrospectively analyzed. These patients were divided into two groups according to their aminotransferase （ALT） level. The sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV）, the likelihood ratio （LR） of aminotransferase/platelet ratio index （APRI） ≥ 1.5 or 〈 1.5 in combination with different hyaluronic acid （HA） cut-off points were calculated for the presence of moderate to severe fibrosis/cirrhosis （fibrosis stages 2 and 4） and no to mild fibrosis/cirrhosis （fibrosis stages 0 and 1）. RESULTS： The APRI correlated with fibrosis stage in CriB patients. The APRI ≥1.5 in combination with a cut-off HA cut-off point 〉 300 ng/mL could detect moderate to severe fibrosis （stages 2-4） in Crib patients. The PPV was 93.7%, the specificity was 98.9%. The APRI 〈 1.5 in combination with different HA cut-off points could not detect no to mild fibrosis in CHB patients. CONCLUSION： The APRI ≥ 1.5 in combination with a HA cut-off point 〉 300 ng/mL can detect moderate to severe fibrosis （stages 2-4） in Crib patients.     

优质护理在慢性乙型病毒性肝炎患者中的临床效果观察

目的研究优质护理策略在慢性乙型病毒性肝炎治疗中的临床效果。方法对入住该院治疗的慢性乙型病毒性肝炎患者106例进行研究,随机分为二组,在常规药物治疗的基础上,对照组给予基础护理,观察组患者给予优质护理策略,包括:宣讲教育、心理护理、饮食护理以及医护人员的管理等。结果观察组患者18个月的HBeAg转阴率、HBV DNA转阴率以及HBeAg/抗-HBe血清转化率均明显高于对照组,二组比较差异有统计学意义(P<0.05);观察组患者生活、饮食、用药等综合生活质量评分均明显高于对照组,差异有统计学意义(P<0.05);观察组临床总有效率为90.6%,明显高于对照组71.7%,二组比较差异有统计学意义(P<0.05)。结论优质护理在慢性乙型病毒性肝炎患者的治疗中具有重要的作用,改善患者疾病状态更明显,可以显著提高生存质量,临床总有效率更高,值得在临床治疗中予以关注。     

慢性乙肝与肝硬化患者血清IL-2、IL-6、HA变化研究

目的探讨慢性乙肝(CHB)与肝硬化(LC)患者血清IL-2、IL-6、HA变化及临床意义。方法选取67例慢性乙肝患者、79例肝硬化患者、58例的同时期体检健康者作为研究对象,分别设为CHB组、LC组与对照组。比较分析三组患者的血清IL-2、IL-6、HA浓度变化。结果 CHB组与LC组患者的血清IL-2、IL-6、HA浓度明显高于对照组,差异有统计学意义(P0.05)。根据Child-Pugh分级,LC组中C级的患者的血清IL-2、IL-6、HA浓度明显高于A、B级患者,差异有统计学意义(P0.05)。结论检测慢性乙肝与肝硬化患者的血清IL-2、IL-6、HA浓度变化,能够对患者的病情及预后进行良好的评估,可以为病情进展提供一定的参考价值。     

糖尿病合并慢性乙肝患者心理护理满意度分析

目的分析心理护理对糖尿病合并慢性乙肝患者的护理效果与满意度。方法在2018年8月-2019年8月内选择该院糖尿病合并慢性乙肝患者60例,采用计算机随机进行分组,其中实验组(心理护理)30例,对照组(常规护理)30例。对比两组患者护理前后的心理状态评分以及对护理的满意度情况。结果实验组护理质量评价满意率高于对照组,实验组心理状态评分均低于对照组,护理后实验组的血糖指标均低于对照组(P<0.05)。结论对糖尿病合并慢性乙肝患者采用心理护理的护理效果显著,改善心理状态与血糖指标、提高护理满意率,值得推广。     

拉米夫定治疗失代偿期乙型肝炎肝硬化疗效观察

目的观察拉米夫定治疗失代偿期乙型肝炎肝硬化的疗效。方法37例失代偿期乙型肝炎肝硬化患者在保肝支持治疗基础上随机分成两组，治疗组19例加用拉米夫定100mg，口服，每日1次，疗程12个月。对照组18例不做任何抗病毒治疗。结果治疗组在治疗12个月后肝功能明显改善：丙氨酸氨基转移酶从89．6±22．8U／L下降到35．2±8．0U／L；总胆红素从61．4±17．3μmol／L下降到39．2±16．5μmol／L，HBV DNA转阴率为84．2％，HBeAg转阴率为47．4％；与对照组比，差异有统计学意义（P〈0．05）。结论拉米夫定通过抑制乙型肝炎病毒复制，可显著改善失代偿期肝硬化患者的肝功能，降低血清HBV DNA载量，使病情稳定，从而延缓肝硬化进展，提高生存质量。     

分析不同抗病毒方案治疗慢性乙型肝炎的价值

目的:分析在慢性乙型肝炎中的最优抗病毒治疗方案及其临床应用价值。方法:抽取院内2017年1月—2018年3月诊治的84例慢性乙型肝炎患者为回顾分析对象,以随机数表法分为观察组和对照组,各42例。对照组以拉米夫定进行抗病毒治疗,观察组改为恩替卡韦抗病毒方案。结果:两组治疗前ALT、AST指标均较高(P>0.05);治疗后观察组ALT、AST指标显著低于对照组(P<0.05);观察组HBV-DNA应答率是97.62%(41/42),高于对照组的85.71%(36/42)(P<0.05);观察组的HBeAg转阴率为61.90%(26/42),高于对照组的40.48%(17/42)(P<0.05);观察组的肝功复常率为92.85%(39/42),高于对照组的73.81%(31/42)(P<0.05)。结论:在慢性乙型肝炎治疗中,采取恩替卡韦的抗病毒方案可取得满意效果,有助于改善肝功能并提升HBV-DNA应答率。     

Expression of SOCS-1 in the liver tissues of chronic hepatitis B and its clinical significance

AIM： To study the expression of suppressor of cytokine signaling-1 （SOCS-1） in the liver tissues of chronic hepatitis 13 （CHB） and the clinical significance of this expression. METHODS： The expression of SOCS-1 in liver tissues of 45 cases of CHB was investigated by immunohistochemical staining, and its correlations with inflammation grades and fibrosis stage were analyzed by SPSS statistics software. RESULTS： The result showed SOCS-1 expressing could be observed in the liver tissue of CriB. The expression of SOCS-1 was mainly distributed near the portal area in the liver tissue of mild inflammation CriB group, and was diffusely distributed in the liver tissue of moderate and severe inflammation groups. SOCS-1 positive stains mainly appear in the hepatocytes, only a few of liver interstitial cells were involved. Inside the hepatocyte, SOCS-1 positive stains are mainly distributed in the plasma. Some of the staining was observed on the membrane. The inclusion bodies in the plasma of hepatocytes were observed occasionally. There were both obvious correlations between the expression of SOCS-1 and the inflammatory grade, and that between the expression of SOCS-1 and the fibrosis stage, CONCLUSION： The distribution of SOCS-1 in the liver tissue of CriB is variable. This expression was correlated with the inflammation grade and fibrosis stage.     

阿德福韦酯治疗慢性乙肝临床疗效观察

选取我院2009年7月~2011年7月收治的78例慢性乙肝患者。随机分为治疗组和对照组各39例。分别使用阿德福韦酯、拉米夫定治疗,分析两组的临床疗效。结果阿德福韦酯疗法在HBV DNA不可测率、HBs Ag转换率等方面相对较高,另外,Knodell HAI评分值下降幅度与HBV DNA下降幅度呈正相关。阿德福韦酯在治疗慢性乙肝方面疗效更显著,可在临床治疗中推广。