| Objective: To discuss the effects of liver tissue pathology with antiviral therapy by interferon and nucleoside analogues for chronic hepatitis b patients and provide theoretical basis for clinical application from the point of view of histology to evaluate the effect of antiviral drugs and treatment necessary to achieve histologic improvement.Methods: In this study,142 patients with twice biopsy-proven chronic hepatitis B for were enrolled to a retrospective cohort. All cases, with least treatment not less than 26 weeks, divided into IFN group, Na S group and non-antiviral group. HBV DNA, HBe Ag and HBs Ag were rechecked in all treatment. Age, gender, HBV DNA and percentage of liver fibrosis were analysis by single factor analysis.Results: 1. Response of virology: HBV DNA were not detected: 58.93% for IFN group(33/56), 90.20% for Na S group(46/51) and 0 for non-antiviral group; Negative conversion radio of HBe Ag: 39.29% for IFN group(22/56), 15.68% for Na S group(7/51) and 6% for non-antiviral group(2/35); Negative conversion radio of HBs Ag: 21.43% for IFN group(12/56), 1.96% for Na S group(1/51) and 0 for non-antiviral group; 2.(1)The interaction between the main effects of treatment, therapy and treatment in the course of liver tissue inflammation: therapy method: F=22.069, P=0.000; course of treatment: F=1.710, P=0.185; interaction: F=3.233, P=0.014.(2)The interaction between the main effects of treatment, therapy and treatment in the course of liver fibrosis: therapy method: F=14.144,P=0.000; course of treatment: F=4.810,P=0.011; interaction: F=2.466,P=0.048.(3)Single factor analysis of variance(G:F=11.417, P=0.000, S:F=10.671, P=0.000): the sixth kinds of combination of the 9 kinds of methods: the best combination of 2 years, the effect of antiviral therapy on liver pathological changes was most obvious.(4) The interaction between the main effects of treatment, therapy and treatment in the course of HBVDNA: therapy method: P=0.000, F=75.777; course of treatment: F=1.424, P=0.244; interaction: F=0.872, P=0.483.(5) Further analysis of variance of 9 kinds of permutations and combinations(F=21.898,P=0.000). The fifth kinds of combination of single factor variance analysis, nucleoside(acid) analogues antiviral treatment in 1-2 years, was the best improved HBVDNA combination, while the 7th, 8th and 9th which were non-antiviral therapy were the worst combination and had no significant improvement in HBV DNA.Conclusion: 1.Both of interferon and nucleoside(acid) analogues antiviral therapy has significantly improved the liver tissue inflammation and fibrosis. 2.With nucleoside(acid) analogues antiviral treatment histologic improvement is most obvious for more than 2 years. 3. Choose effective antiviral treatment of chronic hepatitis b needs to reach a certain time could make obviously histology of patients improved after treatment. |
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