中华实验和临床病毒学杂志
中華實驗和臨床病毒學雜誌
중화실험화림상병독학잡지
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL VIROLOGY
2011年
3期
214-216
,共3页
肝炎,乙型,慢性%丙氨酸氨基转移酶%透明质酸%组织病理学
肝炎,乙型,慢性%丙氨痠氨基轉移酶%透明質痠%組織病理學
간염,을형,만성%병안산안기전이매%투명질산%조직병이학
Hepatitis B,chronic%Alanine aminotransferase%Hyaluronic acid%Histopathology
目的 探讨肝活检病理组织学对慢性乙型肝炎病毒(HBV)携带者和血清ALT轻度升高慢性乙型肝炎患者(CHB)的临床意义.方法 105例慢性HBV感染患者全部进行肝组织活检,并按血清ALT水平分为3组:ALT≤0.5×正常参考值上限(ULN)为A组,0.5×ULN＜ALT≤1×ULN为B组,1×ULN＜ALT＜2×ULN为C组;对3组肝脏炎症程度及纤维化程度比较,并对不同肝组织炎症程度、纤维化程度与患者基本情况的关系进行分析.结果 105例患者中炎症程度≥G2者占40.95%,其中ALT正常的患者有30.43%≥G2;纤维化程度≥S2者占26.67%,其中ALT正常的患者中≥S2者占17.39%.血清ALT及透明质酸随肝脏炎症程度加重及纤维化分期的增加而增加(P＜O.05).结论 密切随访血清ALT和透明质酸可协助了解肝脏病变情况,肝脏病理学依据仍然是决定是否抗病毒治疗的有力依据.
目的 探討肝活檢病理組織學對慢性乙型肝炎病毒(HBV)攜帶者和血清ALT輕度升高慢性乙型肝炎患者(CHB)的臨床意義.方法 105例慢性HBV感染患者全部進行肝組織活檢,併按血清ALT水平分為3組:ALT≤0.5×正常參攷值上限(ULN)為A組,0.5×ULN＜ALT≤1×ULN為B組,1×ULN＜ALT＜2×ULN為C組;對3組肝髒炎癥程度及纖維化程度比較,併對不同肝組織炎癥程度、纖維化程度與患者基本情況的關繫進行分析.結果 105例患者中炎癥程度≥G2者佔40.95%,其中ALT正常的患者有30.43%≥G2;纖維化程度≥S2者佔26.67%,其中ALT正常的患者中≥S2者佔17.39%.血清ALT及透明質痠隨肝髒炎癥程度加重及纖維化分期的增加而增加(P＜O.05).結論 密切隨訪血清ALT和透明質痠可協助瞭解肝髒病變情況,肝髒病理學依據仍然是決定是否抗病毒治療的有力依據.
목적 탐토간활검병리조직학대만성을형간염병독(HBV)휴대자화혈청ALT경도승고만성을형간염환자(CHB)적림상의의.방법 105례만성HBV감염환자전부진행간조직활검,병안혈청ALT수평분위3조:ALT≤0.5×정상삼고치상한(ULN)위A조,0.5×ULN＜ALT≤1×ULN위B조,1×ULN＜ALT＜2×ULN위C조;대3조간장염증정도급섬유화정도비교,병대불동간조직염증정도、섬유화정도여환자기본정황적관계진행분석.결과 105례환자중염증정도≥G2자점40.95%,기중ALT정상적환자유30.43%≥G2;섬유화정도≥S2자점26.67%,기중ALT정상적환자중≥S2자점17.39%.혈청ALT급투명질산수간장염증정도가중급섬유화분기적증가이증가(P＜O.05).결론 밀절수방혈청ALT화투명질산가협조료해간장병변정황,간장병이학의거잉연시결정시부항병독치료적유력의거.
Objective To explore the histopathological features of chronic hepatitis B virus ( HBV) carriers and chronic hepatitis B( CHB) patients with mildly elevated serum alanine aminotransferase ( ALT) . Methods 105 patients were divided into three groups according to serum ALT levels; Croup A [ALT level ≤0. 5 × upper limits of normal ( ULN)] , Group B (0. 5 × ULN ＜ ALT level≤ 1 × ULN) and Group C( 1 × ULN ＜ ALT level ＜ 2 × ULN ). Grade of liver inflammation and stage of liver fibrosis in the three groups were compared. The changes in clinical parameters were then observed in patients who had liver histopathological changes. Results Among 40. 95% of the patients, hepatitis degree went to G2 or even worse; and among 30.43% of the patients whose ALT level were normal, the hepatitis degree reached G2 or even worse. In 26. 67% of the patients, degree of fibrosis went to S2 or even worse, and for the 17. 39% patients whose ALT level were normal, degree of fibrosis went to S2 or even worse. The aggravation of liver inflammation and fibrosis was correlated with ALT and hyaluronic acid increasing ( all P ＜ 0. 05 ) . Conclusions Frequent monitoring of serum ALT and hyaluronic acid may help to understand histopathological changes in the liver. Liver biopsy applied to CHB should be regarded as a main basis if antiviral therapy should be conducted.
