慢性乙型肝炎并非乙醇性脂肪肝98例分析  

Analysis of Clinic and Pathology with Chronic Hepatitis B and Noalcoholic Fatty Liver

作　　者：黄俊达[1] 郑瑞丹[1] 饶日春[1] 杨铮[1] 徐成润[1] 

机构地区：[1]解放军第175医院传染科,福建漳州363000

出　　处：《临床军医杂志》2004年第3期63-64,共2页Clinical Journal of Medical Officers

摘　　要：目的　进一步探讨慢性乙型肝炎并非乙醇性脂肪肝的临床与病理特点。方法　对 98例慢性乙型肝炎并非乙醇性脂肪肝患者进行肝组织活检 ,并检测患者血清乙型肝炎病毒 (HBV)含量、乙型肝炎病毒标志物 (HBV M)、血糖、血脂、丙氨酸氨基转移酶 (ALT)。结果　 63例患者有不同程度的纤维化 ( 64 3 %) ,血糖升高 6例 ( 6 1%) ,高脂血症 15例 ( 15 3 %) ,HBeAg阳性 45例 ( 4 5 9%) ,抗 HBe阳性 5 3例 ( 5 4 1%) ,HBV DNA载量 :10 3～ 10 52 6例、10 5～ 10 715例、>10 719例 ,丙氨酸氨基转移酶 (ALT) 5 0～ 12 0U/L 2 6例 ,<5 0U/L 6例 ,总胆红素 >17 1μmol/L 71例 ,<17 1μmol/L 2 7例。 结论　慢性乙型肝炎合并非乙醇性脂肪肝较常见 ,可伴有糖及血脂的代谢紊乱。慢性乙型肝炎经保肝治疗后HBV DNA阴性、抗 HBe阳性的病人 ,肝功能始终异常 ,临床上应积极行肝组织活检术 ,以排除合并非乙醇性脂肪肝的可能 。Objective To discuss character of clinic and pathology with chronic hepatitis B and noalcoholic fatty livcr.Methods 98 patients with chronic hepatitis B and noalcoholic fatty liver were done in liver by biopsy,and were checked the content of hepatitis virus B in serun,HBV M,FBS,blood fat,ALT.Results 63 patients had different degree fibrosis(64.3%),FBS rise in 6 patients(6.1%),hyperlipidemia 15 patients(15.3%),HBeAg become masculine in 45 patients(45.9%),Anti HBe become masculine in 53 patients(54.1%), content of hepatitis virus B:10 3～10 5 in 26 patients,10 5～10 7 in 15 patients,>10 7 in 19 patients.Conclusion Chronihc hepatitis B and noalcoholic fatty liver was familiar,with FBS and blood fat metabolized confusion.If the liver function of patients with chronic hepatitis B,HBV DNA negative or Anti HBe positive was always abnormal by protect liver tissue treatment,we need to do biopsy in liver in order to get rid of the possibility with noalcoholic fatty liver,and it had determinate value in prognosis judgement.

关 键 词：慢性乙型肝炎 脂肪肝 活组织检查 

分 类 号：R589.2[医药卫生—内分泌]