CAJ | 학술논문

目的观察阿德福韦治疗HBeAg阴性慢性乙型肝炎患者1年后肝组织学改变.方法 30例HBeAg阴性慢性乙型肝炎患者口服阿德福韦酯10 mg,每日1次,服药1年以上,在治疗前、治疗1年后均接受肝穿刺活检.按照Kondell组织学活动指数(HAI)评价肝组织学改变,免疫组织化学法检测肝细胞内HBsAg、HBeAg.结果治疗1年后18例患者肝组织学改善(治疗后HAI积分下降≥2),其中17例患者坏死炎性反应程度改善(治疗后积分下降≥2),11例患者纤维化程度改善(治疗后积分下降≥1).9例患者服药已2年以上,治疗2年时肝病理结果较治疗1年时改善更明显.免疫组织化学法检测显示治疗后肝组织内HBeAg表达明显减少,而HBsAg的表达无显著性改变.结论阿德福韦治疗HBeAg阴性慢性乙型肝炎1年后肝组织学的坏死炎性反应和肝纤维化程度均获明显改善,延长疗程可获得更显著的组织学改善.
목적 관찰아덕복위치료HBeAg음성만성을형간염환자1년후간조직학개변.방법 30례HBeAg음성만성을형간염환자구복아덕복위지10 mg,매일1차,복약1년이상,재치료전、치료1년후균접수간천자활검.안조Kondell조직학활동지수(HAI)평개간조직학개변,면역조직화학법검측간세포내HBsAg、HBeAg.결과 치료1년후18례환자간조직학개선(치료후HAI적분하강≥2),기중17례환자배사염성반응정도개선(치료후적분하강≥2),11례환자섬유화정도개선(치료후적분하강≥1).9례환자복약이2년이상,치료2년시간병리결과교치료1년시개선경명현.면역조직화학법검측현시치료후간조직내HBeAg표체명현감소,이HBsAg적표체무현저성개변.결론 아덕복위치료HBeAg음성만성을형간염1년후간조직학적배사염성반응화간섬유화정도균획명현개선,연장료정가획득경현저적조직학개선.
Objective To investigate hepatic pathohistological changes(including pathology,HBV markers in liver tissue)in patients with KBeAg negative chronic hepatitis B after adefovir therapy for 1 year.Methods 35 patients with HBeAg negative chronic hepatitis B were administered with 10mg adefovir once a day for one year.The needle biopsy of liver were performed before and after treatment.The routine HE stained liver tissue sections were evaluated and Knodell pathological score were done.HBsAg and HBeAg in liver tissue were examined by immunohisochemisty method.Results After 1 year,18,17 and 11 cases had a significant reduction of their total hepatic HAI score,necroinflammation and fibrosis score.The immunohistochemistry examination showed HBeAg in liver decreased significantly,but HBsAg had no obvious alteration.Conclusion Significant improvement in both necroin flammation and fibrosis can be obtained in the majority of patients treated with adefovir for 1 year.More significant improvement in live histology can be obtained after extended treatment.