CAJ | 학술논문

目的：探讨 HBeAg 阴性慢性乙型肝炎（CHB）患者肝组织学与血清学指标改变相关性。方法对135例确诊的HBeAg 阴性 CHB 患者分别进行肝活检和 HBV-DNA 拷贝、血清丙氨酸氨基转移酶（ALT）、总胆红素（TBiL）、天冬氨酸氨基转移酶（AST）、血清清蛋白（ALB）、凝血酶原活动度（PTA）、透明质酸（HA）、层粘连蛋白（LN）检测，并分析组织学检查结果和血清学检查结果相关性。结果血清 HBV-DNA 拷贝水平和各级肝组织炎症分级之间的差异具有统计学意义（χ2＝23.64，P ＜0.05）；高炎症等级血清 ALT、TBiL、AST、ALB、PTA 和 HA 浓度高于低炎症等级，差异具有统计学意义（P ＜0.05）；其中 ALT、TBiL、AST 和 HA 与炎症等级成正相关（P ＜0.05）；ALB 和 PTA 和 HA 与炎症等级成负相关（P ＜0.05）。结论 HBeAg 阴性 CHB 患者 HBV-DNA 拷贝水平、血清 TBiL、ALT、AST、ALB、PTA 浓度和患者的肝组织炎症分级相关，血清 HA 水平和肝组织纤维化水平相关。上述指标能够为 HBeAg 阴性 CHB 患者病情和预后判断提供参考价值。
목적：탐토 HBeAg 음성만성을형간염（CHB）환자간조직학여혈청학지표개변상관성。방법대135례학진적HBeAg 음성 CHB 환자분별진행간활검화 HBV-DNA 고패、혈청병안산안기전이매（ALT）、총담홍소（TBiL）、천동안산안기전이매（AST）、혈청청단백（ALB）、응혈매원활동도（PTA）、투명질산（HA）、층점련단백（LN）검측，병분석조직학검사결과화혈청학검사결과상관성。결과혈청 HBV-DNA 고패수평화각급간조직염증분급지간적차이구유통계학의의（χ2＝23.64，P ＜0.05）；고염증등급혈청 ALT、TBiL、AST、ALB、PTA 화 HA 농도고우저염증등급，차이구유통계학의의（P ＜0.05）；기중 ALT、TBiL、AST 화 HA 여염증등급성정상관（P ＜0.05）；ALB 화 PTA 화 HA 여염증등급성부상관（P ＜0.05）。결론 HBeAg 음성 CHB 환자 HBV-DNA 고패수평、혈청 TBiL、ALT、AST、ALB、PTA 농도화환자적간조직염증분급상관，혈청 HA 수평화간조직섬유화수평상관。상술지표능구위 HBeAg 음성 CHB 환자병정화예후판단제공삼고개치。
Objective To study the correlation between histology and serological index changes in the patients with HBeAg-neg-ative chronic hepatitis B(CHB).Methods 135 cases of HBeAg-negative CHB underwent the liver biopsy,HBV-DNA copy and de-tection of serum alanine aminotransferase(ALT),total bilirubin(TBiL),aspartate aminotransferase(AST),albumin(ALB),pro-thrombin activity(PTA),hyaluronic acid(HA)and laminin(LN).The relationship between the histopathological findings and the se-rological examination results were analyzed.Results There were statistically significant differences between serum HBV-DNA copy levels and the liver tissue inflammation grades(χ2 =23.64,P <0.05);serum ALT,TBiL,AST,ALB,PTA and HA concentrations in the high grade of inflammation were higher than those in the low grade of inflammation,the difference was statistically significant (P <0.05);in which the concentrations of serum ALT,TBiL,AST and HA were positively correlated with the inflammation grades (P <0.05);while ALB and PTA and HA were negatively correlated with the inflammation grades(P <0.05).Conclusion The ser-um level of HBV-DNA copy,TbiL,ALT,AST,ALB and PTA concentrations are related with the inflammatory grade of liver tissue in the patients with HBeAg negative CHB,the serum HA level is related with the fibrosis level of liver tissue.These indicators could provide the reference value for judging the disease condition and prognosis of HBeAg negative CHB patients.