摘要
目的探讨持续ALT正常乙型肝炎肝硬化患者的肝组织病理特征及其相关因素，为临床诊断及治疗提供参考。方法选取2005年1月-2012年12月住院的乙型肝炎肝硬化患者68例，对所有患者进行肝组织病理学检查，分析肝组织病理改变程度与患者年龄、HBVDNA载量、ALT水平的相关性。结果〈30岁的肝组织病变以轻度为主，≥30岁且〈40岁者以中度病变为主，≥40岁者以重度病变为主（P〈0.05）；当HBVDNA载量〉5×10^5拷贝／ml时，以重度改变为主（P〈0.05）；ALT水平为0～20U／L时肝组织以轻度病理改变为主，20～30U／L以中度病理改变为主，30～40U／L以重度病理改变为主（P〈0.05）。结论对ALT持续正常的肝硬化患者，应结合其年龄、HBV DNA载量及ALT水平综合评估，40岁以上、HBVDNA载量〉5×10^5拷贝／ml、ALT水平在30～40U／L的患者，应行肝组织活检以明确疾病有无进展，即使不做肝组织活检，也应予以合理的抗病毒治疗。
Objective TMo investigate the pathological features and related factors of chronic hepatitis B liver cirrhosis patients whose ALT was continued normal, to provide reference for clinical diagnosis and treatment. Methods 68 cases of hepatitis B cirrhosis patients hospitalized from Jan. 2005 to Dec. 2012 were collected. All patients underwent liver biopsy, the correlation of hepatic tissue pathology change degree with age of patients, HBV DNA load, ALT level was analyzed. Results Among 〈 30 years old patients hepatic tissue pathological changes were mild, I〉 30 and 〈40 years old patients were moderate lesions, ≥ 40 years old patients were severe lesions （P 〈 0.05） ; when HBV DNA load was 〉 5 × 10^5 copies/ml, hepatic tissue pathological changes were mainly severe （P 〈 0.05） ; when ALT levels were 0 ～ 20 U/L, hepatic tissue pathological changes were mainly light, when 20 ～ 30 U/L, changes were moderate, when 30 ～ 40 U/L, changes were severe （P 〈 0.05）. Conclusion In patients with cirrhosis persistently normal ALT, comprehensive evaluation should be done combined with the age, HBV DNA load and ALT level. Patients who were above 40 years old, HBV DNA load 〉 5 × 105 copies/ml, ALT levels at 30 -40 U/L should be treated with liver biopsy to confirm the disease progress, even if no liver tissue biopsy, antiviral therapy should also be reasonable.
出处
《胃肠病学和肝病学杂志》
CAS
2014年第2期193-195,共3页
Chinese Journal of Gastroenterology and Hepatology
