ALT轻度升高的慢性HBV感染者临床特征与病理学的关系

李伟; 徐葵花; 赵守松

doi:10.3969/j.issn.1001-5256.2017.11.014

ALT轻度升高的慢性HBV感染者临床特征与病理学的关系

DOI: 10.3969/j.issn.1001-5256.2017.11.014

蚌埠医学院第一附属医院感染科

基金项目:

安徽省教育厅一般项目(学校)(KJ2015B089by)；

详细信息

中图分类号: R512.62
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出版历程
- 收稿日期: 2017-07-31
- 出版日期: 2017-11-20

Association between liver pathology and clinical features in patients with chronic HBV infection and slightly elevated alanine aminotransferase

Department of Infectious Diseases, The First Affiliated Hospital of Bengbu Medical College

Research funding:

摘要

摘要: 目的探讨ALT在12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12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...
- 肝炎,乙型,慢性 /
- 丙氨酸转氨酶 /
- 病理学,临床
Abstract: Objective To 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 HBe Ag, 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.Results The HBe Ag-negative group had significantly higher age and serum ALT level than the HBe Ag-positive group (t=12.35 and 7.18, both P<0.01) .Compared with the HBe Ag-positive group, the HBe Ag-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) .Conclusion Among patients with chronic HBV infection and slightly elevated ALT, HBe Ag-negative patients have significantly worse conditions of liver lesions than HBe Ag-positive patients.Liver biopsy is recommended for older patients with a long course of disease, in order to provide guidance for antiviral therapy.
- hepatitis B, chronic /
- alanine transaminase /
- pathology, clinical

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