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
17期
3094-3097
,共4页
肝炎,乙型,慢性%丙氨酸转氨酶%病理学%临床
肝炎,乙型,慢性%丙氨痠轉氨酶%病理學%臨床
간염,을형,만성%병안산전안매%병이학%림상
Hepatitis B,chronic%Alanine transaminase%Pathology%Clinic
目的：分析ALT轻度升高的慢性乙型肝炎（CHB）患者的肝组织病理学状态与临床关系，为抗病毒治疗提供依据。方法回顾性分析105例ALT轻度升高的CHB患者的肝脏组织病理学情况，根据肝组织不同炎症及纤维化分组，对比各组性别、年龄、ALT、HBV-DNA水平、HBeAg状态差异。结果105例患者均存在不同程度的炎症活动，其中80%（84/105）为G2～G4；67.6%（71/105）存在不同程度的纤维化，其中46.6%（49/105）为S2～S4。不同肝组织炎症分级间性别、年龄、HBV-DNA水平、HBeAg状态比较均无统计学意义（P＞0.05）；不同纤维化分期间年龄比较， S1、S3、S4组与S0组差异具有统计学意义（P＜0.05），性别、ALT、HBV-DNA水平、HBeAg状态在各组间比较无统计学意义（P＞0.05）。结论 ALT 轻度升高的 CHB 患者可能存在明显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輕度升高的慢性乙型肝炎（CHB）患者的肝組織病理學狀態與臨床關繫，為抗病毒治療提供依據。方法迴顧性分析105例ALT輕度升高的CHB患者的肝髒組織病理學情況，根據肝組織不同炎癥及纖維化分組，對比各組性彆、年齡、ALT、HBV-DNA水平、HBeAg狀態差異。結果105例患者均存在不同程度的炎癥活動，其中80%（84/105）為G2～G4；67.6%（71/105）存在不同程度的纖維化，其中46.6%（49/105）為S2～S4。不同肝組織炎癥分級間性彆、年齡、HBV-DNA水平、HBeAg狀態比較均無統計學意義（P＞0.05）；不同纖維化分期間年齡比較， S1、S3、S4組與S0組差異具有統計學意義（P＜0.05），性彆、ALT、HBV-DNA水平、HBeAg狀態在各組間比較無統計學意義（P＞0.05）。結論 ALT 輕度升高的 CHB 患者可能存在明顯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：분석ALT경도승고적만성을형간염（CHB）환자적간조직병이학상태여림상관계，위항병독치료제공의거。방법회고성분석105례ALT경도승고적CHB환자적간장조직병이학정황，근거간조직불동염증급섬유화분조，대비각조성별、년령、ALT、HBV-DNA수평、HBeAg상태차이。결과105례환자균존재불동정도적염증활동，기중80%（84/105）위G2～G4；67.6%（71/105）존재불동정도적섬유화，기중46.6%（49/105）위S2～S4。불동간조직염증분급간성별、년령、HBV-DNA수평、HBeAg상태비교균무통계학의의（P＞0.05）；불동섬유화분기간년령비교， S1、S3、S4조여S0조차이구유통계학의의（P＜0.05），성별、ALT、HBV-DNA수평、HBeAg상태재각조간비교무통계학의의（P＞0.05）。결론 ALT 경도승고적 CHB 환자가능존재명현적간조직병이학개변，응적겁고필행간천자활검，급시학정항병독치료시궤。
Objective To study the liver histological changes in chronic hepatitis B(CHB) patients with mild elevation of serum alanine aminotransferase (ALT) and the related clinic factors, providing basis for antiviral therapy.Methods105 CHB patients with mild elevation of ALT were included in this study. Their liver histological changes and the relationship between these changes and gender, age, HBV-DNA level, HBeAg status of patients were retrospectively analyzed.ResultsAmong 105 patients, 100% (105/105) had different degrees of inflammation, 80% (84/105) were G2-G4; 67.6% (71/105) had different degrees of fibrosis, 46.6% (49/105) were S2-S4. There were no significant differences between different grades of inflammation in patients with gender, age, ALT level, HBV-DNA level, HBeAg status. Age increased as the stage of fibrosis increased, and there were significant differences between S1, S3, S4 and S0. But there were no significant differences between different stages of fibrosis in patients with gender, ALT level, HBV-DNA level, HBeAg status.Conclusion There may be obvious change of liver histopathology in CHB patients with mild elevation of ALT, who should be considered for liver biopsy, in order to determine the timing of antiretroviral therapy without delay.
