CAJ | 학술논문

目的了解不同肝脏病理炎症分级的慢性乙型肝炎患者生化学和病毒学临床特征的差异.方法回顾分析我院428例接受肝脏穿刺病理活检术的慢性乙型肝炎患者,肝功能、HBeAg和HBV DNA水平同时进行测定；根据肝脏炎症病理分级分为四组；利用SPSS16.0软件,统计分析不同肝脏炎症病理分级的患者的生化学、病理学和病毒学等指标.结果平均年龄和性别构成比在四组患者中无差异；外周血ALT、AST、TBil、ALB和PTA均存在差异,均有统计学意义(P＜0.05).G3组患者ALT水平最高,明显高于G00-1组(P =0.001),其余各组之间差异均无统计学意义(P＞0.05)；G3组、G4组患者AST水平明显高于G0-1组、G2组(P＜0.05),但是G3与G4、G0-1组和G2之间差异无统计学意义(P＞0.05).G4组TBil水平明显高于G0-1、G2和G3三组(P＜0.05),而三组之间比较差异无统计学意义(P＞0.05).G2与G3组患者ALB水平差异无统计学意义(P＞0.05),其余各组之间比较差异均有统计学意义(P＜0.05).四组患者的PTA值组间比较差异均有统计学意义(P＜0.05).四组患者的HBV DNA水平、肝脏组织的HBsAg和HBcAg表达水平、四组患者血清中HBeAg阳性和阴性患者所占比率无差异(P＞0.05).结论 ALT、AST、TBiL、ALB和PTA在不同肝脏病理分级的慢性乙型肝炎患者存在差异；均在一定程度上可反映肝脏的炎症分级；ALT和PTA作为反映G0-1、G2和G3肝脏炎症分级的指标；ASL、TBil、ALB、PTA来反映G3与G4患者肝脏炎症的指标.HBVDNA水平和HBeAg状态与肝脏炎症分级无关.
목적 료해불동간장병리염증분급적만성을형간염환자생화학화병독학림상특정적차이.방법 회고분석아원428례접수간장천자병리활검술적만성을형간염환자,간공능、HBeAg화HBV DNA수평동시진행측정；근거간장염증병리분급분위사조；이용SPSS16.0연건,통계분석불동간장염증병리분급적환자적생화학、병이학화병독학등지표.결과 평균년령화성별구성비재사조환자중무차이；외주혈ALT、AST、TBil、ALB화PTA균존재차이,균유통계학의의(P＜0.05).G3조환자ALT수평최고,명현고우G00-1조(P =0.001),기여각조지간차이균무통계학의의(P＞0.05)；G3조、G4조환자AST수평명현고우G0-1조、G2조(P＜0.05),단시G3여G4、G0-1조화G2지간차이무통계학의의(P＞0.05).G4조TBil수평명현고우G0-1、G2화G3삼조(P＜0.05),이삼조지간비교차이무통계학의의(P＞0.05).G2여G3조환자ALB수평차이무통계학의의(P＞0.05),기여각조지간비교차이균유통계학의의(P＜0.05).사조환자적PTA치조간비교차이균유통계학의의(P＜0.05).사조환자적HBV DNA수평、간장조직적HBsAg화HBcAg표체수평、사조환자혈청중HBeAg양성화음성환자소점비솔무차이(P＞0.05).결론 ALT、AST、TBiL、ALB화PTA재불동간장병리분급적만성을형간염환자존재차이；균재일정정도상가반영간장적염증분급；ALT화PTA작위반영G0-1、G2화G3간장염증분급적지표；ASL、TBil、ALB、PTA래반영G3여G4환자간장염증적지표.HBVDNA수평화HBeAg상태여간장염증분급무관.
Objective The aim of this study was to compare the biochemical and virological characteristics among patients infected with hepatitis B virus (HBV) according to pathologic inflammation grade.Methods 428 patients with chronic HBV infection accept liver biopsy,liver function test,HBeAg detection and HBV DNA levels detection.They were studied and subdivided into four groups according to pathologic inflammation grade.The biochemical and virological characteristics were studied.Univariate analysis was performed with the SPSS 16.0.Results In different inflammation grading group,mean age and sex composition were no difference.Serum levels of ALT was highest in group G3 and lowet in group G0-1,there was statistically significant among groups (P =0.005) ;AST and TBil were all highest in group G4 and lowest in group G0-1,statistically significant also found among groups (P =0.000&0.004).Serum levels of ALB and PTA were all highest in group G0-1 and lowest in group G4,had statistically significant among groups (P =0.000&0.000).There was no difference of HBV DNA level and percentage of HBeAg (+) among four groups (P =0.565&0.065).Conclusions The serum AST,TBil,ALB and PTA were different and can partly reflect the inflammation degree of liver damage in patients with HBV infection.ALT and PTA can reflect the inflammation degree of G0-1,G2 and G3 ;AST,TBil,ALB and PTA reflect the G3 and G4.HBV DNA level and HBeAg status can not indicate the inflammation degree in HBV infection patients.