标题：Fibroscan在转氨酶轻度升高慢乙肝患者抗病毒中的应用价值

      作者：张倩华，蔡遐，高齐明，高文军    (中山市第二人民医院肝病科，广东 中山 528400)

      卷次： 2017年28卷2期

      【摘要】 目的 分析肝纤维化扫描仪(Fibroscan)在转氨酶轻度升高慢乙肝患者抗病毒治疗中的应用价值。方法 回顾性分析2011年1月至2014年12月在我院肝病科治疗的169例转氨酶轻度升慢乙肝患者的临床资料，根据治疗方式的不同分为抗病毒组109例及护肝组60例，两组患者均实施乙肝病毒基因(HBV DNA)、谷丙转氨酶(ALT)及Fibroscan检测，抗病毒组患者选择核苷类的抗病毒药治疗，护肝组则选择复方甘草酸苷、双环醇及五酯胶囊治疗，比较治疗前及治疗1年后两组患者的HBV DNA、ALT及Fibroscan值等指标水平。结果 抗病毒组患者治疗前的HBV DNA、ALT及Fibroscan值分别为(6.25±1.14)×103 U/mL、(58.38±10.49) U/L及(11.98±2.32) kPa，与护肝组患者的(6.07±1.32)×103 U/mL、(55.91±8.05) U/L及(11.31±2.04) kPa比较差异均无统计学意义(P>0.05)；治疗1年后，抗病毒组患者的HBV DNA、ALT及Fibroscan值分别为(1.99±0.52)×103 U/mL、(33.01±11.55) U/L及(7.97±1.95) kPa，较治疗前明显下降，差异均有统计学意义(P<0.05)。治疗 1年后，护肝组的HBV DNA、ALT及Fibroscan值分别为(5.97±1.06)×103 U/mL、(53.28±7.06) U/L及(11.14±2.93) kPa，较治疗前无明显变化，差异均无统计学意义(P>0.05)。结论 Fibroscan对肝功能轻度异常的慢乙肝患者实施抗病毒治疗具有较好的指导作用，其同时还应能监测HBVDNA及ALT等指标水平，值得临床重视。
      【关键词】 肝纤维化扫描仪；转氨酶轻度升高；慢乙肝；抗病毒；应用价值
      【中图分类号】 R512.6+2 【文献标识码】 A 【文章编号】 1003—6350（2017）02—0217—03

Application value of Fibroscan in the antiviral treatment of patients of chronic hepatitis B virus with slightlyelevated transaminase.
ZHANG Qian-hua, CAI Xia, GAO Qi-ming, GAO Wen-jun. Department of Liver Disease, theSecond People's Hospital of Zhongshan City, Zhongshan 528400, Guangdong, CHINA
【Abstract】 Objective To analyze the application value of Fibroscan in the antiviral treatment of chronic hepati-tis B (CHB) patients with slightly elevated transaminase during. Methods The clinical data of 169 CHB patients withslightly elevated transaminase from January 2011 to December 2014 in Department of Liver Disease in our hospital wereretrospectively analyzed. According to the different treatment, the patients were divided into antiviral group (109 cases)and liver-protecting group (60 cases). The two groups of patients all underwent hepatitis B virus (HBV) gene (HBVDNA), glutamic-pyruvic transaminase (ALT) and Fibroscan detection. The antiviral group applied nucleoside antiviraldrug for treatment, while the liver-protecting group applied compound glycyrrhizin, bicyclol and five-ester capsule for liv-er protection therapy. The levels of HBV DNA, ALT Fibroscan values before treatment and 1 year after treatment werecompared. Results Before treatment, the levels of HBV DNA, ALT and Fibroscan value in the antiviral group patientswere (6.25±1.14)×103 U/mL, (58.38±10.49) U/L and (11.98±2.32) kPa, which showed no statistically significant differencewith those in the liver-protecting group of (6.07±1.32)×103 U/mL, (55.91±8.05) U/L and (11.31±2.04) kPa (P>0.05). Oneyear after treatment, the levels of HBV DNA, ALT and Fibroscan value in antiviral group were (1.99±0.52)×103 U/mL,(33.01±11.55) U/L and (7.97±1.95) kPa, which were significantly decreased compared with those before treatment (P<0.05), and the levels in liver-protecting group were (5.97±1.06)×103 U/mL, (53.28±7.06) U/L and (11.14±2.93) kPa,which showed no significant difference with those before treatment (P>0.05). Conclusion Fibroscan has significantguiding effect in the antiviral treatment of chronic hepatitis B patients with slightly abnormal liver function, and at thesame time it can also monitor the levels of HBV DNA and ALT, which is worthy of clinical attention.
      【Key words】 Fibroscan; Slightly elevated transaminase; Chronic hepatitis B; Antiviral; Application value·论 著·doi:10.3969/j.issn.1003-6350.2017.02.015基金项目：广东省中山市科学技术局计划项目(编号：2014A1FC081)