慢性乙型肝炎病毒感染肝脏病理变化及丙氨基酸转移酶与病毒学关系研究  

Pathological changes in liver with chronic HBV infections and virological relationship with biochemical ALT

作　　者：邵建平 李迪华 汪闰月 

机构地区：[1]江山贝林医院检验科,浙江江山324100

出　　处：《中华医院感染学杂志》2014年第20期4979-4981,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81071515)

摘　　要：目的研究慢性乙型肝炎病毒(HBV)感染患者肝脏丙氨基酸转移酶(ALT)和病理变化与病毒学关系,为疾病诊治提供依据。方法选择2012年6月-2013年5月医院肝脏病科收治的40例慢性HBV感染者作研究对象,对其血清ALT、乙型肝炎病毒基因(HBV-DNA)进行检测,并完成肝活检病理检查,数据采用SPSS13.0统计软件进行处理。结果随肝脏炎症活动度、肝脏纤维化程度加重、HBV-DNA水平均无明显变化,而ALT水平均显著升高,差异有统计学意义(P<0.05);慢性HBV感染和HBsAg携带者ALT水平为(29.7±9.7)U/L、(25.4±7.8)U/L,而HBeAg阴性和HBeAg阳性者ALT水平较高,分别为(151.5±138.8)U/L、(226.1±248.6)U/L,差异有统计学意义(P<0.05),以HBsAg携带者、HBeAg阴性、HBeAg阳性、慢性HBV感染排列为顺序,HBV-DNA水平有升高表现,差异有统计学意义(P<0.05)。结论肝脏炎症活动度与ALT有明显相关性,但在对其他引起ALT轻微升高的病因进行排除的基础上,应行肝穿刺病理检查,为是否需要抗病毒治疗提供依据,可更为合理、准确地实施慢性乙型肝炎诊治。OBJECTIVE To investigate ALT in patients with chronic HBV infection and pathological changes of liver biochemistry and virological relationship . METHODS Totally 40 patients with chronic HBV infection hospitalized in the liver department from Jun .2012 to May 2013 were selected and were detected for serum ALT and HBV-DNA and completed liver biopsy for pathological examination .Clinical data were processed by SPSS 13 .0 .RESULTS With the increase of severity of hepatic inflammation activity and hepatic fibrosis ,there were no significant changes in the HBV-DNA level ,while the ALT level showed significant increase （P〈0 .05） .The ALT level in patients with chronic HBV infection and HBsAg carriers was （29 .7 ± 9 .7） U/L ,and （25 .4 ± 7 .8） U/L and was significantly higher in the HBeAg negative （151 .5 ± 138 .8） U/L and the HBeAg positive （226 .1 ± 248 .6） U/L patients （P〈 0 .05） .The HBV-DNA level showed an increasing trend in the order of HBsAg carriers ,HBeAg negative patients , HBeAg positive patients and patients with chronic HBV infection , the difference was statistically significant （P〈 0 .05） .CONCLUSIONS Liver inflammation activity is significantly correlated with ALT ,but on the basis of exclusion of other causes which slightly elevated ALT ,liver biopsy examination should be performed ,as to provide evidence of antiviral therapy in order to conduct more reasonable and accurate treatment for chronic hepatitis B .

关 键 词：慢性乙型肝炎病毒 感染 肝脏病理 丙氨基酸转移酶 病理学 

分 类 号：R512.62[医药卫生—内科学]