摘要
目的研究HBsAg阴性乙型肝炎的临床特点、血清HBV标志物、HBVDNA水平、肝脏病理变化及肝组织HBsAg和HBcAg的表达情况。方法回顾性分析45例HBsAg阴性乙型肝炎患者的临床资料,所有患者均进行了肝组织活检和病理免疫组化检测。结果在45例患者中,23例(51.1%)感染途径不明,25例(55.5%)无任何自觉症状,肝功能异常和病理损害均为轻度,但8例(17.8%)肝脏病理诊断为早期肝硬化;45例患者肝组织HBsAg和(或)HB-cAg均有至少一项阳性;43例(95.6%)患者血清抗-HBs、抗-HBe和抗-HBc出现单独或联合阳性,而仅4例(8.9%)血清HBVDNA阳性。结论HBsAg阴性乙型肝炎起病隐匿,临床症状、肝功能变化和病理损害相对较轻,但其危害不容忽视,明确诊断需检测血清HBVDNA和(或)肝组织HBsAg和HBcAg。
Objective To study the clinical features, HBV markers, HBV DNA levels, pathological changes, HBsAg and HBcAg expression in liver tissues of patients with occult hepatitis B. Methods A retrospective investigation of clinical data was performed in 45 cases with occult hepatitis B. The liver biopsy tissues were pathologically and immunohistochemically examined. Results In 45 patients, 23 cases had no obvious exposure routes, 25 cases were asymptomatic, and most had slight liver function test abnormality and pathological lesions. However, 8 cases were pathologically diagnosed with cirrhosis. HBsAg and/or HBcAg in liver tissues were all positive in 45 cases, of which 43 had single or combining anti-HBs,anti-HBe and anti-HBc positive. Only 4 were found serum HBV DNA positive. Conclusion Hepatitis B with serum HBsAg negative usually manifests occult and the liver tissue changes develop slowly, and its clinical features ,liver function tests and pathological lesions are relatively slight, but it＇s severity should not be neglected. Serum HBV DNA and HBsAg/HbcAg in liver tissues should be examined to identify the patients with occult hepatitis B.
出处
《实用肝脏病杂志》
CAS
2007年第5期301-302,308,共3页
Journal of Practical Hepatology
基金
广州市医药卫生科技项目(2005-YB-179)
