血清丙氨酸转氨酶轻度升高的慢性乙型肝炎临床流行病学横断面调查分析  

Clinical epidemiology cross-sectional survey and analysis of chronic hepatitis B with ALT 1～2×ULN

作　　者：刘顺庆[1,2] 朱晓骏[1,2] 孙学华[1,2] 李曼[1,2] 周振华[1,2] 周碧霞[1,2] 余卓[1,2] 马翼[3] 高月求[1,2] 张旭峰[3] 

机构地区：[1]上海中医药大学附属曙光医院肝病科,上海201203 [2]上海市中医临床重点实验室 [3]上海中医药大学附属曙光医院检验科

出　　处：《中西医结合肝病杂志》2012年第3期167-169,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家科技重大专项资助项目(2008ZX1005-006);国家自然科学基金(No.81102570;81072792);国家中医药管理局中医肝胆病重点学科(No.2010sh);上海市自然科学基金(10ZR1430990);上海市科委优秀学科带头人(10XD1404100);上海市教育委员会重点学科(第五期)建设资助项目(J50370);上海高校创新团队项目(第一期);上海中医药大学优秀团队培养计划

摘　　要：目的:研究血清丙氨酸转氨酶(ALT)轻度升高(ALT 1～2×ULN)的慢性乙型肝炎(CHB)临床流行病学特点。方法:用多中心、大样本、横断面临床流行病学调查方法,采集此类患者的一般资料及实验室、影像学检查结果,用SPSS 17.0统计软件进行统计学分析。结果:ALT轻度升高CHB患者男女比例为2.5∶1,主要集中在21～40岁年龄段,HBeAg阳性与HBeAg阴性患者分别占65.1%和34.9%。肝功能除ALT平均水平轻度升高外,其他指标的平均水平均无明显异常。血清HBV DNA水平复制较高。彩色多普勒超声检查显示有超过2/3的患者肝脏回声增粗;超过1/3的患者肝内血管欠清晰。尽管血清ALT轻度升高,但绝大部分的患者都存在中度以上的肝脏炎症及不同程度的肝纤维化。结论:ALT轻度升高的CHB患者需要密切随访及监测其肝功能及HBV DNA水平,或建议其行肝穿刺以及早进行抗病毒治疗,以延缓病情的进展及并发症的过早发生。Abstract Objective： To investigate the clinical epidemiology character of chronic hepatitis B with ALT between 1× ULN and 2× ULN. Methods： Multicenter, large sample and prospectiveness study methods were used in our study. We collected the general information of the patients with ALT 1- 2 ×ULN, and the results of their laboratory tests and imaging diagnostic re- ports. The SPSS software package （version 17. 0） was used for the statistic analysis. Results： The ratio for male and female of CHB wtih ALT 1 - 2 × ULN was 2. 5 ： 1. A large number of the patients was put togather between 21 and 40 years of age. The per- centage of HBeAg positive and HBeAg negative patients were 65.1% and 34. 9% , respectively. For these patients, except for the mild higher of the serum ALT level, the other indicators of liver function tests were nearly normal. Virological tests showed a high level of serum HBV DNA replication in the patients. The uhrasonography of the liver parenchyma in more than two thirds of these cases presented a rough echo, and at the same time over one third patients showed that intrahepatic vessles lacked of clari- ty. Although a mild high level of serum alanine aminotransferase , the results of liver tissue biopsy demonstrated up to moderate lesions of inflammation and variable degrees of fibrosis in a great many of cases. Conclusion： In order to delay the process of the disease and prevent liver cirrhosis, hepatocellular carcinoma and any other complications, patients with chronic hepatitis B （ ALT 1 - 2 × ULN） should be required to conduct a close follow - up or asvised to undertake liver biopsy so as to be given anti- viral therapy as soon as possible.

关 键 词：慢性乙型肝炎(ALT1~2×ULN) 流行病学 横断面 调查分析 

分 类 号：R512.62[医药卫生—内科学]