中国肝脏病杂志（电子版）
中國肝髒病雜誌（電子版）
중국간장병잡지（전자판）
CHINESE JOURNAL OF LIVER DISEASES(ELECTRONIC VERSION)
2014年
2期
1-5
,共5页
廖雪姣%何清%杨大国%艾书玲%唐奇远%敖飞健%白冰%李知玉%赵连三
廖雪姣%何清%楊大國%艾書玲%唐奇遠%敖飛健%白冰%李知玉%趙連三
료설교%하청%양대국%애서령%당기원%오비건%백빙%리지옥%조련삼
肝炎,乙型,慢性%自然史%肝纤维化%演变规律
肝炎,乙型,慢性%自然史%肝纖維化%縯變規律
간염,을형,만성%자연사%간섬유화%연변규률
Hepatitis B,chronic%Natural history%Hepatic ifbrosis%Evolution rules
目的：研究慢性HBV感染者自然史各期中肝组织纤维化演变规律。方法按照《慢性乙型肝炎防治指南（2010年版）》描述的CHB自然史分期的血清学特征作为纳入标准，将慢性HBV感染者分为免疫耐受期、免疫清除期、非活动或低（非）复制期以及再活动期，统计和分析各组患者的性别、年龄、ALT水平、血清HBV DNA、肝组织炎症（G）的变化特点，以及各组肝组织纤维化（S）的演变规律。结果共637例患者，其中男性501例（78.6%），女性136例（21.4%）。免疫耐受期患者101例，免疫清除期患者248例，低（非）复制期患者119例，再活动期患者169例。各期患者的相应肝组织炎症分级比较均有统计学意义，其中免疫清除期和再活动期肝组织炎症较为活跃（χ2=150.424， P ＜0.0001）。各期患者肝纤维化分期亦有统计学差异，其纤维化程度呈渐次加重的趋势（χ2=141.682，P＜0.0001）。结论慢性HBV感染者自然史表现为肝组织炎症反复活跃、肝组织纤维化程度进行性加重的过程。
目的：研究慢性HBV感染者自然史各期中肝組織纖維化縯變規律。方法按照《慢性乙型肝炎防治指南（2010年版）》描述的CHB自然史分期的血清學特徵作為納入標準，將慢性HBV感染者分為免疫耐受期、免疫清除期、非活動或低（非）複製期以及再活動期，統計和分析各組患者的性彆、年齡、ALT水平、血清HBV DNA、肝組織炎癥（G）的變化特點，以及各組肝組織纖維化（S）的縯變規律。結果共637例患者，其中男性501例（78.6%），女性136例（21.4%）。免疫耐受期患者101例，免疫清除期患者248例，低（非）複製期患者119例，再活動期患者169例。各期患者的相應肝組織炎癥分級比較均有統計學意義，其中免疫清除期和再活動期肝組織炎癥較為活躍（χ2=150.424， P ＜0.0001）。各期患者肝纖維化分期亦有統計學差異，其纖維化程度呈漸次加重的趨勢（χ2=141.682，P＜0.0001）。結論慢性HBV感染者自然史錶現為肝組織炎癥反複活躍、肝組織纖維化程度進行性加重的過程。
목적：연구만성HBV감염자자연사각기중간조직섬유화연변규률。방법안조《만성을형간염방치지남（2010년판）》묘술적CHB자연사분기적혈청학특정작위납입표준，장만성HBV감염자분위면역내수기、면역청제기、비활동혹저（비）복제기이급재활동기，통계화분석각조환자적성별、년령、ALT수평、혈청HBV DNA、간조직염증（G）적변화특점，이급각조간조직섬유화（S）적연변규률。결과공637례환자，기중남성501례（78.6%），녀성136례（21.4%）。면역내수기환자101례，면역청제기환자248례，저（비）복제기환자119례，재활동기환자169례。각기환자적상응간조직염증분급비교균유통계학의의，기중면역청제기화재활동기간조직염증교위활약（χ2=150.424， P ＜0.0001）。각기환자간섬유화분기역유통계학차이，기섬유화정도정점차가중적추세（χ2=141.682，P＜0.0001）。결론만성HBV감염자자연사표현위간조직염증반복활약、간조직섬유화정도진행성가중적과정。
Objective To study the evolution rules of hepatic fibrosis in the different stages of the natural history of chronic HBV infection. Methods We collected patients of chronic HBV infection and divided them into four phases (the immune tolerant phase, the immune clearance phase, the low or non-replicative phase, the reactivation phase) by the standard of the Guidelines for Chronic Hepatitis B in China, version 2010. The evolution rules of ages, ALT levels, HBV DNA loads, liver tissue inlfammation and hepatic ifbrosis were analyzed. Results Total of 637 patients (501 males and 136 females) with chronic HBV infection in the natural history were recruited in this study. The 101 patients in immune tolerant phase, and 248 patients of the immune clearance phase were analyzed, 119 patients of the low or non-replicative phase were detected, 169 patients of the reactivation phase were included. The signiifcant difference was determined in the liver tissue inlfammation, especially the immune clearance phase and the reactivation phase were much active (χ2=150.424, P<0.0001). The ifbrosis stage among the four stages in the natural history of the HBV infection also had signiifcant difference, and gradually increased (χ2=141.682, P<0.0001). Conclusions The natural history of the chronic HBV infectious was a process that the liver ifbrosis was progressive exacerbation, that the liver tissue inlfammation was repeatedly active.
