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HBV DNA低水平患者的肝组织炎症活动度及相关因素分析
Liver inflammatory activity in chronic hepatitis B patients with a low HBV DNA level and related factors
文章发布日期:2018年12月17日  来源:  作者:刘立,刘春云,杜映荣,等  点击次数:252次  下载次数:78次

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【摘要】:根据炎症活动分级分为G1组(n=44)、G2组(n=84)和G3组(n=9)。所有患者均进行肝穿刺活组织检查和肝组织免疫组化,分析炎症分级与患者年龄、性别、感染HBV时间、肝功能、HBsAg水平、HBV DNA载量、基因型、门静脉内径、脾静脉内径、脾脏厚度等的关系。等级资料多组间比较采用Kruskal-Wallis H检验。结果137例患者中HBeAg阴性126例,其中G1 42例(33.33%),G2 77例(61.11%),G3 7例(5.56%);HBeAg阳性11例,G1 2例(18.18%),G2 7例(63.64%),G3 2例(1818%)。 126例 HBeAg阴性患者G1、G2、G3 3组间比较,Glo、HBV DNA、PLT、脾静脉内径和脾脏厚度比较差异均有统计学意义(H值分别为6.189、7.168、8.624、8.170、8.522,P值均<0.05)。结论低水平HBV DNA患者中,有相当比例的患者炎症分级≥G2,具有抗病毒治疗的指征,且其炎症分级与Glo、HBV DNA、PLT、脾静脉内径和脾脏厚度密切相关。
【Abstract】:ObjectiveTo investigate the association between liver inflammatory activity and clinical features in chronic hepatitis B (CHB) patients with a low HBV DNA level, and to provide a basis for judging the condition of such patients. MethodsA total of 137 patients with an HBV DNA level of 20-2000 IU/ml who were treated in The Third People′s Hospital of Kunming from January 2014 to December 2017 were enrolled, and according to the grade of liver inflammatory activity, they were divided into G1 group with 44 patients, G2 group with 84 patients, and G3 group with 9 patients. Liver biopsy and immunohistochemistry were performed for all patients, and the association of the grade of liver inflammatory activity with age, sex, HBV infection time, liver function, HBsAg level, HBV DNA load, genotype, diameter of the portal vein, diameter of the splenic vein, and spleen thickness was analyzed. The Kruskal-Wallis H test was used for comparison of nonparametric ranked data between multiple groups. ResultsOf all 137 patients, 126 had negative HBeAg, among whom 42 (33.33%) had G1 inflammation, 77 (61.11%) had G2 inflammation, and 7 (5.56%) had G3 inflammation; 11 had positive HBeAg, among whom 2 (18.18%) had G1 inflammation, 7 (63.64%) had G2 inflammation, and 2 (18.18%) had G3 inflammation. There were significant differences in globulin, HBV DNA load, platelet count (PLT), diameter of the splenic vein, and spleen thickness between the 126 HBeAg-negative patients with different inflammation grades (H=6.189, 7.168, 8.624, 8.170, and 8.522, all P<0.05). ConclusionThe majority of patients with a low HBV DNA level have ≥G2 liver inflammation and the indication for antiviral therapy, and the grade of inflammation is closely associated with globulin, HBV DNA load, PLT, diameter of the splenic vein, and spleen thickness.
【关键字】:病毒载量; 炎症活动度; 病理学, 临床
【Key words】:viral load; inflammation grades; pathology, clinical
【引证本文】:LIU L, LIU CY, DU YR, et al. Liver inflammatory activity in chronic hepatitis B patients with a low HBV DNA level and related factors[J]. J Clin Hepatol, 2019, 35(1): 77-81. (in Chinese)
刘立,刘春云,杜映荣, 等. HBV DNA低水平患者的肝组织炎症活动度及相关因素分析[J]. 临床肝胆病杂志, 2019, 35(1): 77-81.

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