中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
13期
2420-2423
,共4页
肝炎,乙型,慢性%丙氨酸转氨酶%病理学
肝炎,乙型,慢性%丙氨痠轉氨酶%病理學
간염,을형,만성%병안산전안매%병이학
Hepatitis B,chronic%Alanine transaminase%Pathology
目的：分析ALT持续正常的慢性HBV感染者的肝脏病理与临床关系，为抗病毒治疗提供依据。方法回顾性分析82例ALT持续正常的慢性HBV感染者肝脏病理情况，根据肝组织不同炎症及纤维化分组，对比各组性别、年龄、家族史、HBV-DNA水平、HBeAg状态差异。结果82例患者中，100%（82/82）存在不同程度的炎症活动，其中58.5%（48/82）的患者炎症活动度≥G2；57.3%（47/82）存在不同程度的纤维化，其中43.9%（36/82）的患者纤维化分期≥S2；纤维化分期与炎症分级相关（r＝0.428，P＜0.01）；不同炎症分级患者的性别、年龄、家族史、HBV-DNA水平、血清HBeAg比较无统计学差异；不同纤维化分期患者年龄随纤维化分期的增加呈增大趋势，其中S2、S3组年龄（＞40岁）与S0组相比，差异具有统计学意义（P＜0.05），余性别、家族史、HBV-DNA水平、血清HBeAg表达比较无统计学差异。结论对于ALT水平持续正常的慢性HBV感染者，特别是年龄＞40岁，可能存在不同程度的肝组织病理学改变，应积极考虑行肝穿刺活检，及时确定抗病毒治疗时机。
目的：分析ALT持續正常的慢性HBV感染者的肝髒病理與臨床關繫，為抗病毒治療提供依據。方法迴顧性分析82例ALT持續正常的慢性HBV感染者肝髒病理情況，根據肝組織不同炎癥及纖維化分組，對比各組性彆、年齡、傢族史、HBV-DNA水平、HBeAg狀態差異。結果82例患者中，100%（82/82）存在不同程度的炎癥活動，其中58.5%（48/82）的患者炎癥活動度≥G2；57.3%（47/82）存在不同程度的纖維化，其中43.9%（36/82）的患者纖維化分期≥S2；纖維化分期與炎癥分級相關（r＝0.428，P＜0.01）；不同炎癥分級患者的性彆、年齡、傢族史、HBV-DNA水平、血清HBeAg比較無統計學差異；不同纖維化分期患者年齡隨纖維化分期的增加呈增大趨勢，其中S2、S3組年齡（＞40歲）與S0組相比，差異具有統計學意義（P＜0.05），餘性彆、傢族史、HBV-DNA水平、血清HBeAg錶達比較無統計學差異。結論對于ALT水平持續正常的慢性HBV感染者，特彆是年齡＞40歲，可能存在不同程度的肝組織病理學改變，應積極攷慮行肝穿刺活檢，及時確定抗病毒治療時機。
목적：분석ALT지속정상적만성HBV감염자적간장병리여림상관계，위항병독치료제공의거。방법회고성분석82례ALT지속정상적만성HBV감염자간장병리정황，근거간조직불동염증급섬유화분조，대비각조성별、년령、가족사、HBV-DNA수평、HBeAg상태차이。결과82례환자중，100%（82/82）존재불동정도적염증활동，기중58.5%（48/82）적환자염증활동도≥G2；57.3%（47/82）존재불동정도적섬유화，기중43.9%（36/82）적환자섬유화분기≥S2；섬유화분기여염증분급상관（r＝0.428，P＜0.01）；불동염증분급환자적성별、년령、가족사、HBV-DNA수평、혈청HBeAg비교무통계학차이；불동섬유화분기환자년령수섬유화분기적증가정증대추세，기중S2、S3조년령（＞40세）여S0조상비，차이구유통계학의의（P＜0.05），여성별、가족사、HBV-DNA수평、혈청HBeAg표체비교무통계학차이。결론대우ALT수평지속정상적만성HBV감염자，특별시년령＞40세，가능존재불동정도적간조직병이학개변，응적겁고필행간천자활검，급시학정항병독치료시궤。
Objective To study the liver histological changes in chronic hepatitis B(CHB) patients with persistently normal serum alanine aminotransferase (ALT) levels and the related clinic factors, providing the basis for antiviral therapy.Methods 82 CHB patients with persistently normal ALT were included in this study. Their liver histological changes and the relationship between these changes and sex, age, family history, HBV-DNA level, HBeAg status of patients were retrospectively analyzed. Results Among these 82 patients, 100%(82/82) had different degrees of inflammatory activity, of whom 58.5% (48/82) was higher than or equal to grade 2; 57.3%(47/82) had different degrees of fibrosis, of whom 43.9% (36/82) were higher than or equal to stage 2.Stage of fibrosis correlated positively with grade of inflammation(r=0.428,P<0.01). There were no significant differences between different grades of inflammation in patients with gender, age, family history, the level of serum HBV-DNA, HBeAg status. Age increased as the stage of fibrosis increased, and there were significant differences between S2, S3 (age>40 years) and S0. But there were no significant differences between different stages of fibrosis in patients with gender, family history, the level of serum HBV-DNA, HBeAg status.Conclusion There may be different degrees of liver histopathology in chronic hepatitis B patients with persistently normal ALT levels, especially those older than 40 years, should be considered for liver biopsy, in order to determine the timing of antiretroviral therapy without delay.
