首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 11期原发性胆汁性胆管炎 => 病毒性肝炎 =>ALT轻度升高的慢性HBV感..
ALT轻度升高的慢性HBV感染者临床特征与病理学的关系
Association between liver pathology and clinical features in patients with chronic HBV infection and slightly elevated alanine aminotransferase
文章发布日期:2017年10月11日  来源:  作者:李伟,徐葵花,赵守松  点击次数:140次  下载次数:25次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的探讨ALT在1~2倍正常值上限的慢性HBV感染者肝组织病理学改变和临床特征之间的关系。方法收集2015年7月-2016年12月于蚌埠医学院第一附属医院住院的80例ALT水平在1~2正常值上限的慢性HBV感染者,所有患者行肝穿刺活组织检查,根据HBeAg阳性(n=42)或阴性(n=38)分为2组,并分析其肝组织病理学改变与患者年龄、性别、HBV DNA载量等的关系。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果HBeAg阴性患者的年龄、血清ALT水平明显高于HBeAg阳性患者,差异均有统计学意义(t值分别为12.35、7.18,P值均<0.01)。HBeAg阴性组中炎症程度≥G2患者的比例、纤维化程度≥S2患者的比例均高于HBeAg阳性组,差异有统计学意义(54.8% vs 76.3%,χ2=53.68,P<0.01;57.1% vs 73.7%,χ2=46.67,P<0.01)。共有35例患者予免疫组化染色法显示肝组织内HBsAg和HBcAg的表达,2组患者肝组织内HBsAg和HBcAg的免疫染色评分差异均无统计学意义(P值均>0.05)。结论对于ALT轻度升高的慢性HBV感染者,HBeAg阴性患者的肝脏病变明显重于HBeAg阳性患者,对年龄较大、病程较长的患者,均建议行肝穿刺活组织检查,对指导抗病毒治疗具有积极意义。
【Abstract】:ObjectiveTo investigate the association between liver pathological changes and clinical features in patients with chronic HBV infection and alanine aminotransferase (ALT) 1-2×upper limits of normal (ULN). Methods A total of 80 patients with chronic HBV infection and ALT 1-2×ULN who were hospitalized in The First Affiliated Hospital of Bengbu Medical College from July 2015 to December 2016 were enrolled. All patients underwent liver biopsy, and according to positive or negative HBeAg, these patients were divided into two groups, and the association of liver pathological changes with age, sex, and HBV DNA load was analyzed. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe HBeAg-negative group had significantly higher age and serum ALT level than the HBeAg-positive group (t=12.35 and 7.18, both P<0.01). Compared with the HBeAg-positive group, the HBeAg-negative group had a significantly higher proportion of patients with liver inflammation ≥G2 (54.8% vs 76.3%, χ2=53.68, P<0.01) or fibrosis degree ≥S2 (57.1% vs 73.7%, χ2=46.67, P<0.01). Immunohistochemical staining was performed for 35 patients to measure the expression of HBsAg and HBcAg in the liver, and there were no significant differences in the staining scores of HBsAg and HBcAg between the two groups (both P>0.05). ConclusionAmong patients with chronic HBV infection and slightly elevated ALT, HBeAg-negative patients have significantly worse conditions of liver lesions than HBeAg-positive patients. Liver biopsy is recommended for older patients with a long course of disease, in order to provide guidance for antiviral therapy.
【关键字】:肝炎, 乙型, 慢性; 丙氨酸转氨酶; 病理学, 临床
【Key words】:hepatitis B, chronic; alanine transaminase; pathology, clinical
【引证本文】:李伟, 徐葵花, 赵守松. ALT轻度升高的慢性HBV感染者临床特征与病理学的关系[J]. 临床肝胆病杂志, 2017, 33(11): 2123-2126.

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号