实用肝脏病杂志 ›› 2012, Vol. 15 ›› Issue (1): 7-9.doi: 10.3969/j.issn.1672-5069.2012.01.003

• 病毒性肝炎 • 上一篇    下一篇

40例慢性乙型肝炎轻度患者肝组织病理学变化研究

苗雅娇, 赵守松   

  1. 233004 安徽省蚌埠市 蚌埠医学院第一附属医院感染病科
  • 收稿日期:2011-08-02 出版日期:2012-02-10 发布日期:2016-05-11
  • 通讯作者: 赵守松,E-mail: zss20006@yahoo.com.cn
  • 作者简介:苗雅娇 女,27岁,硕士研究生,主要从事病毒性肝炎发病机制研究。E-mail:miaoyajiao@163.com

The pathologic changes of liver tissues in 40 adult hepatitis B viral infection patients with normal or mildly elevated serum ALT levels

Miao Yajiao, Zhao Shousong   

  1. Department of Infections Diseases,The First Affiliated Hospital,Bengbu Medical College,Bengbu 233004,Anhui Province
  • Received:2011-08-02 Online:2012-02-10 Published:2016-05-11

摘要: 目的探讨40例成人谷丙酶正常或轻度升高的慢性HBV感染者肝组织病理学的变化。方法常规进行肝穿刺组织学检查,对肝组织进行炎症分级及纤维化分期;采用化学发光法对该组患者进行血清HA、LN、PCⅢ、CⅣ水平的检测;应用全自动生化仪检测主要血生化指标。分析上述血清学指标水平与肝组织炎症分级及纤维化分期之间的关系。结果在40例慢性HBV感染者中,G1S03例,G1S19例,G1S21例,G1S33例,G1S44例,G2S110例, G2S23例,G2S44例,G3S42例,G4S41例;肝组织炎症分级和纤维化分期<G2S2组血清ALT、ALB及CHE水平较≥G2S2组有所增加,血清AST、TBIL水平较≥G2S2组有所减少,其中仅血清AST水平在两组间有显著性差异(P<0.05),血清ALT、TBIL、ALB、CHE水平在组间均无统计学差异(P>0.05)。肝组织纤维化分期≥S2组血清HA、LN、PCⅢ、CⅣ水平较<S2组均有所增加,其中血清HA、PCⅢ、CⅣ水平在组间有统计学差异(P<0.05),而血清LN水平在组间无显著性差异(P>0.05)。结论对成人ALT正常或轻度升高的HBV感染者应及时行肝穿刺活检,以便作出正确的诊断和及时处理,防止病情向肝硬化、肝癌的进展。

关键词: 慢性乙型肝炎, 肝活检, 血清肝纤维化指标

Abstract: Objective To explore the pathologic changes in 40 adult patients with chronic HBV infection who were with normal or mildly elevated serum ALT levels.Method To analyze the relation of hepatic pathologic grades indexes and fiberized stages indexes,detected by liver biopsy,serum markers of liver fibrosis(HA,LN,PCⅢ,CⅣ),detected by chemiluminescence method,main Liver function ,detected by automatic biochemistry analyzer,of 40 patients with chronic hepatitis B infection.ResultsIn 40 patients with chronic hepatitis B infection,the liver pathologic manifestations were G1S0 in three,G1S1 in nine,G1S2 in one,G1S3 in three,G1S4 in four,G2S1 in ten,G2S2 in three,G2S4 in four,G3S4 in two,and G4S4 in one;The serum ALT,ALB and CHE levels in patients with liver inflammation grade and fibrosis stage<G2S2 were higher than that in with≥G2S2,the serum AST and TBIL levels in patients with liver inflammation grade and fibrosis stage<G2S2 were lower than that in with≥G2S2,showing a significant differences in serum AST levels(P<0.05) in two groups.The serum HA,PCⅢ and CⅣ levels in patients with liver fibrosis stage≥S2 were higher than that in with<S2 (P<0.05),but no significant differences in the serum LN levels was shown(P>0.05).Conclusion The liver biopsies in HBV infected patients with normal or mild abnormal ALT should be performed in time to guide antiviral treatment and prevent the progression of the disease to liver cirrhosis and liver cancer.

Key words: Hepatitis B, Liver biopsy, Serum liver fibrosis index