摘要
目的分析中国标准血清丙氨酸转氨酶(ALT)正常慢性乙型肝炎病毒(HBV)感染患者肝组织病理学特征改变,以期引起临床重视。方法回顾性分析2005年10月-2015年9月787例接受肝脏穿刺活检术的ALT正常慢性HBV感染患者临床资料、肝组织炎症活动度(G)及纤维化程度(S);数据采用SPSS 17.0软件进行统计分析。结果 787例患者大部分存在不同程度的病理损伤,其中≥G2者234例,≥S2者235例;男性患者年龄和e抗原阴性的构成均高于女性患者,差异有统计学意义(P<0.05);年龄随着G和S的增加而增加,差异均有统计学意义(P<0.01)。结论近30.00%ALT正常慢性HBV感染者存在明显肝组织炎症活动和肝纤维化,对>30岁人群推荐行肝活组织检查,尤其是HBeAg阴性且HBV DNA≥103拷贝/ml的男性患者,对HBV DNA<103拷贝/ml的HBeAg阴性患者应进行高灵敏度和精确度的HBV DNA检测。
OBJECTIVE To analyze the liver pathology and the clinical characteristics of chronic HBV infection patients with normal alanine aminotransferase（ALT）related to Chinese national standard reference interval,so as to cause attention to clinical management.METHODS The data of liver inflammation pathological grading（G）and fibrosis stage（S）and clinical characteristics in 787 cases had chronic HBV infection with percutanous transshepatic biopsy from Oct.2005 to Sep.2015 were analyzed retrospectively.SPSS 17.0 was used for data analysis.RESULTS In 787 cases,most with pathological injury in different levels,there were 234cases（29.73%）≥G2and 235cases（29.86%）≥S2.The average age and constituent ratio of HBeAg negative in male group were significantly higher than that in female group（P〈0.05）,the same as the constituent ratios of≥G2and≥S2（χ2=5.072,9.733;P=0.002,0.024）.Along with the increase of age,the degrees of G and S aggravated,and the difference was significant（P〈0.01）.CONCLUSIONThere are still liver structural damage with≥G2and≥S2in almost 30 per cent chronic HBV infected patients with normal ALT.Liver histopathological examination should be considered in aged 30 years and over,especially in male patients with HBeAg negative and HBV DNA≥103 copies/mL.We should pay attention to the screening of high sensitivity and accuracy detection of HBV DNA for HBeAg negative patients with HBV DNA103 copies/mL.
作者
胡爱荣
蒋素文
颜华东
金珊珊
胡耀仁
HU Ai-rong JIANG Su-wen YAN Hua-dong JIN Shan-shan HU Yao-ren(Ningbo No. 2 Hospital, Ningbo, Zhejiang 315010, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第23期5354-5357,共4页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生省部培育计划项目(2014PYA018)
浙江省区域专病中心建设专科项目(2014-98)
宁波市科技计划社发重大项目(2016C51005)
关键词
乙型肝炎病毒
丙氨酸转氨酶
病理学
肝
Hepatitis B virus
Alanine aminotransferase
Pathology
Liver
