HBsAg血清转换后乙型肝炎患者的临床与病理特点  

The clinical and pathological features of hepatitis B patients after HBsAg seroconversion

作　　者：王欣欣[1] 王泰龄[2] 张立洁[1] 孟忻[1] 宋晨朝[1] 孙琳[1] 赵景民 张世杰[1] 

机构地区：[1]首都医科大学附属北京佑安医院病理科,北京100069 [2]北京中日友好医院病理科 [3]解放军三○二医院病理科

出　　处：《中华传染病杂志》2008年第2期88-91,共4页Chinese Journal of Infectious Diseases

基　　金：北京市科技计划重大项目资助项目（H020920020290）

摘　　要：目的观察HBsAg阴转出现抗-HBs后，乙型肝炎患者的临床与病理学特征。方法收集21例血清HBsAg阴转、出现抗-HBs的乙型肝炎患者，总结其临床特点，苏木精-伊红染色、Masson三色、Gomori网织纤维染色及HBsAg、HBcAg免疫组织化学染色分析肝穿刺组织病理形态特征。结果21例乙型肝炎患者均有急性肝炎史，无肝炎家族史，血清抗-HBs、抗-HBe、抗-HBc阳性；其中2例血清HBV DNA检测阳性，分别为4．9×10^3和2．3×10^4拷贝／mL；组织学观察18例有轻度慢性炎性反应，15例有轻度纤维化；肝组织中HBsAg、HBcAg免疫组织化学染色均阴性。结论发生HBsAg血清转换的乙型肝炎患者仍有肝脏炎性反应和纤维化，但病变较轻。Objective To observe the clinical and pathological features of hepatitis B patients after HBsAg seroconversion. Methods The clinical information of 21 hepatitis B cases of HBsAg seroconversion was summarized. The pathological features of their liver tissue samples taken by liver puncture were analyzed by hematoxylin-eosin （H-E）, Masson, Gomori, and H BsAg/HBcAg immunohistochemical stainings. Results All of the 21 cases had history of acute hepatitis B without hepatitis B family history. The anti-HBs, anti-HBe and anti-HBc in sera were all positive and in two of them HBV DNA were detected （4.9 × 10^3 copy/mL and 2.3 × 10^4 copy/mL respectively）, Among 21 these patients, there were 18 case presenting mild chronic hepatitis and 15 developing mild fibrosis. The immunohistochemical stainings were all negative for HBsAg and HBcAg. Conclusions The 21 hepatitis B cases of HBsAg seroconversion are all adults who were infected by hepatitis B virus naturally. The lesions in the liver show mild inflammation and fibrosis.

关 键 词：肝炎 乙型 血清转换 活组织检查 肝炎E抗原 乙型 

分 类 号：R512.62[医药卫生—内科学]