摘要
目的:了解丙氨酸氨基转移酶(ALT)正常慢性乙型肝炎病毒(HBV)感染者肝脏病理改变,并分析其与血清HBV-DNA、HBeAg的关系。方法:回顾性分析138例ALT正常慢性HBV感染者,所有患者均行肝组织活检,同时检测血清HBV-DNA和乙肝病毒标志物。结果:138例患者中,仅5.1%的患者肝组织病理学检查完全正常,31.9%的患者肝脏炎症≥G2和(或)纤维化≥S2。HBeAg阳性组与HBeAg阴性组之间,炎症分级、纤维化分期无差异,P>0.05。HBeAg阴性患者中,HBV-DNA≥10 000 IU/mL组炎症≥G2、纤维化≥S2比例达60%、73.3%,显著高于HBV-DNA<10 000 IU/mL组患者,P<0.05。结论:绝大部分ALT正常慢性HBV感染者肝组织内仍有潜在肝炎活动;1/3的患者有显著肝组织病变,需抗病毒治疗;HBeAg阴性患者,若HBV-DNA≥10 000 IU/mL,应当行肝组织活检明确病情,及时治疗。
Objective To study the liver pathological changes of chronic HBV cariers with normal alanine aminotransferase（ALT） level and its relationships with erum HBV-DNA and serum HBeAg.Methods 138 cases of chronic HBV cariers with normal ALT level were retrospectively analyzed.Histopathologic examinations for liver tissues were performed in all patients,and the serum HBV-DNA and hepatitis B markers were also detected.Results Of all the cases,only 5.1% of them were found to be normal using pathological examination,31.9% of them with inflammation or fibrosis（≥ G2 or ≥ S2）.No significantly difference（P 0.05） in the grades of inflammation or fibrosis was found between HBeAg（＋） group and HBeAg（-） group.Among the HBeAg（-） cases,the rate of the patients（HBV-DNA ≥ 10 000 IU / ml）with significant inflammation and fibrosis were 60% and 73.3%,respectively,and were of,significantly higher（P 0.05） than that of patients in the group（HBV-DNA 10 000 IU / ml）.Conclusion Inflammation and fibrosis were found in liver tissues of most chronic HBV cariers with normal ALT level.Significant liver tissue lesions were detected in one third of them and antiviral therapy need to be used for these patients.The patients with HBeAg negative and HBV-DNA ≥ 10 000 IU / mL should be examined using liver biopsies and then to be treated in time.
出处
《实用医学杂志》
CAS
北大核心
2013年第10期1637-1639,共3页
The Journal of Practical Medicine
