肝脏彩色多普勒超声异常的慢性乙型肝炎病毒携带者肝组织病理特点及意义  

Color Doppler sonography and liver biopsy examination of chronic hepatitis B virus carriers

作　　者：陈素梅[1] 邓勇[1] 

机构地区：[1]福建医科大学附属泉州市第一医院感染科,福建泉州362000

出　　处：《中国病毒病杂志》2013年第1期55-58,共4页Chinese Journal of Viral Diseases

摘　　要：目的研究彩色多普勒超声(彩超)提示肝实质回声增粗慢性乙型肝炎携带者肝组织炎症及纤维化程度,为诊治提供参考。方法对74例彩超提示肝实质回声增粗的慢性乙型肝炎病毒携带者进行肝穿刺活检术,通过化学发光法定量检测HBeAg及实时定量荧光检测HBV DNA,分析其与肝组织病理炎症及纤维化分期之间的关系。结果≥30岁患者纤维化分期≥S2的比例(73.2%,30/41)高于<30岁的患者(48.5%,16/33),差异有统计学意义(χ2=4.74,P<0.05);HBeAg阴性组纤维化分期≥S2患者比例(78.4%,29/37)高于HBeAg阳性组患者(45.9%,17/37),差异有统计学意义(χ2=8.27,P<0.05);HBV DNA阴性组纤维化分期≥S2患者的比例(75.0%,12/16)与HBV DNA阳性组患者(58.6%,34/58)相比,差异无统计学意义(χ2=1.43,P>0.05)。结论≥30岁HBeAg阴性彩超提示肝实质回声增粗的患者纤维化分期≥S2者的比例较高,对此类患者建议行肝脏穿刺活检术,必要时予以相应治疗,以防止病情进展。Objective To study the pathology and immunohistochemistry of liver biopsy in chronic hepatitis B virus（HBV）carriers with coarsening echoes detected by color Doppler ultrasound,and provide a reference for the diagnosis and treatment of hepatitis B.Methods Liver puncture biopsy was done in 74 HBV carriers whose ultrasonography examination prompted coarsening liver parenchyma echo.HBeAg was measured by quantitative chemiluminescence,HBV DNA by quantitative real-time fluorescence.Liver inflammation and fibrosis staging was assessed as well.Results Among the 74 enrolled HBV carriers in the study,there were more patients whose liver fibrosis stages are at 2 or more severer among those of 30 years or older（30/41,73.2%）than that（16/33,48.5%）in the group of younger than 30 years old（χ2=4.74,P0.05）;more HBeAg（-）（29/37,78.4%）than HBeAg（＋）patients（17/37,45.9%）were enrolled（χ2=8.27,P0.05）;there is no significant difference in the number of patients between HBV DNA（-）and HBV DNA（＋）groups（12/16,75% vs 34/58,58.6%;χ2=8.27,P 0.05）.Conclusions Coarsening echoes in Doppler sonography may suggest mild or severe liver fibrosis of HBV carriers.

关 键 词：肝炎 乙型 慢性 携带者 肝穿刺活检术 彩色多普勒超声 

分 类 号：R512.62[医药卫生—内科学]