慢性乙型肝炎患者肝组织病理学分析

实用肝脏病杂志 ›› 2010, Vol. 13 ›› Issue (1): 26-27.

慢性乙型肝炎患者肝组织病理学分析

钮志林, 高胜利, 俞净, 徐密琴, 沈燕, 叶扬, 谭友文

215200 江苏省吴江市南通大学附属吴江医院感染病科（钮志林高胜利俞净徐密琴沈燕叶扬）; 江苏省镇江市第三人民医院（谭友文）

收稿日期:2009-08-31 出版日期:2010-02-10 发布日期:2016-04-18
通讯作者: 高胜利,E-mail：gaoyuvictory@qq.com
作者简介:钮志林男,45岁,讲师,副主任医师。从事病毒性肝炎的临床和教学工作。E-mail：wjnzl@yahoo.cn
基金资助:
江苏省吴江市科技局社会发展课题项目（WS200805）

Pathological and clinical analysis of liver biopsies in patients with chronic hepatitis B

NIU Zhiling, GAO Shengli, YU Jing, et al.

Department of Infectious Diseases,Affiliated Hospital,Nantong University,Wujiang 215200,Jiangsu

Received:2009-08-31 Online:2010-02-10 Published:2016-04-18

摘要/Abstract

摘要： 目的探讨慢性乙型肝炎患者肝组织病理学与临床血生化指标的相关性。方法对252例慢性乙型肝炎患者肝穿活组织病理学检查结果与血清HBV DNA、肝功能等血生化指标进行统计学分析。结果肝组织炎症活动度与纤维化分期无明显的相关性（r_s=-0.132,P=0.579）;肝组织G4期患者血清ALT和PT水平明显高于G1期患者（P<O.05）;血清HBV DNA水平与肝组织炎性活动度和纤维化程度无明显的相关性（P>0.01）。结论肝组织活检在肝脏病情评估中的作用是其它检查所不能代替的。

关键词: 慢性乙型肝炎, HBV DNA, 肝组织病理

Abstract: Objective To investigate the relationship among serum HBV DNA,ALT,ALB,PT levels and liver tissue injuries in patients with chronic hepatitis B. Methods Routine biochemical liver function tests and serum HBV DNA levels were assayed in 252 patients with chronic hepatitis B,and the liver biopsies were performed and the grading and staging of the liver were routinely obtained. Results There was not obvious correlation between the inflammatory grading and fibrotic staging;Serum ALT and PT in patients with G4 were significantly higher than in with G1;Serum HBV DNA levels was not correlated with histological activity index or firbosis. Conclusion Liver biopsy still plays an unique role in judging the pathogenetic condition of liver in patients with chronic hepatitis B.

Key words: Hepatitis B, HBV DNA, Liver tissue, Pathology

钮志林, 高胜利, 俞净, 徐密琴, 沈燕, 叶扬, 谭友文. 慢性乙型肝炎患者肝组织病理学分析[J]. 实用肝脏病杂志, 2010, 13(1): 26-27.

NIU Zhiling, GAO Shengli, YU Jing, et al.. Pathological and clinical analysis of liver biopsies in patients with chronic hepatitis B[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2010, 13(1): 26-27.

参考文献

[1] KEEFFE EB,DIETERICH DT,HAN SH,et al. A treatment algorithm for the management of chronic hepatitis B virus infection in the United States：2008 update[J]. Clin Gastroenterol Hepatol,2008,6（12）：1315-1341.
[2] LOK AS,MCMAHON BJ. Chronic hepatitis B：update 2009[J]. Hepatology,2009,50（3）：661-662.
[3] FOUCHER J,CASTERA L,BERNARD PH,et al. Prevalence and factors associated with failure of liver stiffness measurement using FibroScan in a prospective study of 2114 examinations[J]. J Gastroenterol Hepatol,2006,18（4）：411-412.
[4] WAI CT,CHENG CL,WEE A,et al. Non-invasive models for predicting histology in patients with chronic hepatitis B[J]. Liver Int,2006,26（6）：666-672.
[5] LEBENSZTEJN DM,SKIBA E,SOBANIEC-LOTOWSKA M,et al. A simple noninvasive index （APRI） predicts advanced liver fibrosis in children with chronic hepatitis B[J]. Hepatology,2005,41（6）：1434-1435.
[6] 中华医学会传染病与寄生虫病学分会和肝病学分会. 病毒性肝炎防治方案[J]. 中华肝脏病杂志. 2000,8（6）：324-329.
[7] 赵登蕴,覃亚勤,刘贵章,等. 慢性HBV感染者临床与病理诊断的此较——附187例报告[J]. 实用肝脏病杂志,2007,10（5）：318-319.
[8] BATALLER R,NORTH KE,BRENNER DA. Genetic polymorphisms and the progression of liver fibrosis：a critical appraisal[J]. Hepatology,2003,37（3）：493-503.
[9] FALLETI E,FABRIS C,TONIUTTO P,et al. Genetic polymorphisms of inflammatory cytokines and liver fibrosis progression due to recurrent hepatitis C[J]. Interferon Cytokine Res,2007,27（3）：239-246.
[10] PAPATHEODORIDIS GV,PARASKEVIS D. Role of genetic polymorphisms in the progression of liver fibrosis in chronic hepatitis C virus infection[J]. Liver Int,2008,28（6）：764-766.
[11] YIM HJ,LOK AS. Natural history of chronic hepatitis B virus infection：what we knew in 1981 and what we know in 2005[J]. Hepatology,2006,43（2 Suppl 1）：S173-S181.
[12] CHU CJ,HUSSAIN M,LOK AS. Quantitative serum HBV DNA levels during different stages of chronic hepatitis B infection[J]. Hepatology,2002,36（6）：1408-1415.
[13] LAI M,HYATT BJ,NASSER I,et al. The clinical significance of persistently normal ALT in chronic hepatitis B infection[J]. Hepatology,2007,47（6）：760-767.
[14] 龙辉,罗红涛,赖春颜,等. 丙氨酸氨基转移酶低水平慢性乙型肝炎患者的肝脏病理分析[J]. 广东医学,2008,22（10）：1672-1674.
[15] 张玉果,南月敏. 慢性乙型肝炎临床与病理的对比分析[J]. 国际消化病杂志,2007,15（6）：468-469.