| Objective:To explore the correlation between quality of life(QOL)and aspartate aminotransferase to platelet ratio(APRI),liver stiffness measurement(LSM)and histopathology in patients of chronic hwpatitis B with liver fibrosis after antiviral treatment with Entecavir.Methods:From October 2013 to March 2015,95 patients diagnosed of chronic hepatitis B with liver fibrosis in Yanbian University Affiliated Hospital were selected These patients were also eligible for serological HBeAg-positive viral load detection of HBV DNA>2 × 104 IU/ml;HBeAg-negative viral load detection of HBV DNA>2 × 103 IU/ml.All patients underwent antiviral treatment with Entecavir,The SF-36 scale was chosen for assessment of QOL,LSM values were measured by transient elastography and serum APRI was measured before treatment,and at 26 weeks,52 weeks,and 78 weeks after the treatment,31 patients underwent liver biopsy and histopathological examination before treatment and at 78 weeks after treatment to observe the degree of inflammation and fibrosis,and the QOL,APRI,LSM and histology,before and after antiviral treatment were analyzed.Results:(1)After antiviral treatment,the QOL of all patients showed an overall upward trend.The general health,role-physical,social functioning,bodily pain and vitality improved after 26 weeks,52 weeks,and 78 weeks of treatment,and the difference was statistically significant(P<0.05),The role-emotional was improved at 26 weeks and 78 weeks after treatmemt,and the diffence was statistically significant(P<0.05).(2)The APRI of all patients showed a downward trend,the values before treatment,at 26 weeks,at 52 weeks,and at 78 weeks after the treatment were 1.05,0.51,0.61,and 0.46,respectively,The most significant decrease was observed at 26 weeks,and the decrease to the lowest at 78 weeks,There was a statistically significant difference between pre-4reatment and post-treatment(P<0.01),The difference was statistically significant(P<0.05)at 52 weeks and 78 weeks.APRI was negatively correlated with general health,physical functioning,role-hyyscal,role-emotional,ocial functioning,bodily pain and vitality(3)The LSM of all patients showed a downward trend The values before treatment,at 26 weeks,52 weeks,and 78 weeks after the treatment were 16.20,10.35,8.40,and 8.25,respectively,The decline was most obvious at the 26th week of the treatment,The difference was statistically significant(P<0.01)before and after treatment,The differences between 26 weeks and 52 weeks and 78 weeks(P<0.05)were statistically significant.LSM was negatively correlated with with general health,physical functioning,role-physical,role-emotional,bodily pain and mental health.(4)The QOL of liver biopsy patients showed an overall upward trend.The general health increased at 26 weeks,52 weeks and 78 weeks treatment,The difference was statistically significant(P<0.05),bodily pain was ameliorated at 26 weeks and 78 weeks after threatment,the difference was statistically significant(P<0.05).The histological inflammation was reduced by 88%and fibrosis was reduced by 60%after antiviral treatment.Conclusion:(1)Entecavir antiviral treatment can improve the QOL in patients of chronic hepatitis B with liver fibrosis;(2)APRI and LSM values are negatively correlated with QOL,suggesting that the decline of APRI and LSM values can predict the improvement of QOL in patients of chronic hepatitis B with liver fibrrois;(3)Improvement of liver histologic inflammation and fibrosis have certain effect on the QOL in patients of chronic hepatitis B with liver fibrosis. |
