CAJ | 학술논문

目的从病理组织学和免疫组织化学改变的角度分析拉米夫定的疗效.方法 13例慢性乙型肝炎患者予拉米夫定100 mg/d,连用1年.治疗前后在超声导向下行肝脏活检,切片HE染色和网纤染色,对炎症活动度(HAI)和纤维化程度作计分评价.HBsAg和HBcAg用免疫组化(LSAB)法检测.结果 13例患者拉米夫定治疗后血清HBV DNA全部转为阴性(＜1.6 pg/ml),组织学炎症活动度计分由5.23±2.99降为3.54±1.55(P＜0.05);纤维化程度计分由2.61±1.15降为1.92±1.21(P＞0.05).免疫组化5例HBsAg由弥漫性胞浆型表达转变为散在包涵体样型表达,其中4例HBcAg由胞浆型表达为主转变为核型表达为主.结论拉米夫定持续用药可使肝组织炎症活动度计分尤其是碎屑坏死改善(P＜0.05);血清HBV DNA阴转,肝组织HBsAg、HBcAg表达量减少.
목적 종병리조직학화면역조직화학개변적각도분석랍미부정적료효.방법 13례만성을형간염환자여랍미부정100 mg/d,련용1년.치료전후재초성도향하행간장활검,절편HE염색화망섬염색,대염증활동도(HAI)화섬유화정도작계분평개.HBsAg화HBcAg용면역조화(LSAB)법검측.결과 13례환자랍미부정치료후혈청HBV DNA전부전위음성(＜1.6 pg/ml),조직학염증활동도계분유5.23±2.99강위3.54±1.55(P＜0.05);섬유화정도계분유2.61±1.15강위1.92±1.21(P＞0.05).면역조화5례HBsAg유미만성포장형표체전변위산재포함체양형표체,기중4례HBcAg유포장형표체위주전변위핵형표체위주.결론 랍미부정지속용약가사간조직염증활동도계분우기시쇄설배사개선(P＜0.05);혈청HBV DNA음전,간조직HBsAg、HBcAg표체량감소.
Objective To evaluate the liver histopathological changes of the chronic hepatitis B patients treated with lamivudine.Methods 13 chronic hepatitis B patients received 100 nag lamivudine orally dailv for 52 weeks.The liver biopcies were obtained before and after treatment.The liver sections were stained with HE,Gorden Swat and Masson methods.HBsAg and HBcAg were examined by immunohistochemisty method Results The HAI,score reduced from 5.23±2.99 to 3.54±1.55(P＜0.05)after treatment with lamivudine,while the fibrosis score reduced from 2.61±1.15 to 1.92±1.21(P＞0.05).ExPression type of HBsAg changed from mainly in cytoplasm to inclusion body-like in 5 patients,and expression type of HBcAg also changed from mainly in cytoplasm to nucleus in 4 patients.All patients became HBV DNA negative during treatment(＜1.6/ml,liquid quantitative hybridisation assay,Abbott).Conelusions These results suggested that prolonged suppression of viral replication by lamivudine could significantly improve liver histologieai activity index,especially piecemeal necrosis,Lamivudine therapy lowered the expression of HBsAg,HBcAg in hepatocytes,induced the change of expression types.Persistent viral suppression with lamivudine might eventually slow down the development of liver fibrosis.