慢性乙型肝炎患者肝组织病理改变的影响因素  

The influencing factors of liver histopathological change in patients with chronic hepatitis B

作　　者：陈红波[1] 张媛袁 陆晓梅[2] 黄鹏[2] 徐银[2] 喻荣彬[2] 苏静[2] 

机构地区：[1]句容市人民医院感染科,江苏句容212400 [2]南京医科大学公共卫生学院流行病与卫生统计学系,江苏南京211166

出　　处：《中华疾病控制杂志》2015年第2期123-126,共4页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金青年项目(81102164);江苏高校优势学科建设工程资助项目(PAPD)

摘　　要：目的 了解影响谷丙转氨酶（alanine aminotransferase,ALT）正常和轻度异常的慢性乙型肝炎（简称乙肝）患者肝组织病理学特征的因素。方法 对句容市人民医院2008年9月～2013年5月的住院慢性乙肝患者的治疗数据进行分析,根据肝组织病理炎症或者纤维化是否达到2级（期）,把52例ALT≤2×ULN的慢性乙型肝炎患者分为两组,比较不同年龄、血生化指标和病毒学指标之间的差异。结果 肝组织高纤维化或炎症组白蛋白（albumin,ALB）水平低于低纤维化或炎症组,且差异有统计学意义（t=2.45,P=0.018）。HBeAg阴性患者的ALT、谷草转氨酶（casparate aminotrans ferase,AST）及总胆红素（total bilirubin,Tbil）均高于阳性患者,但差异均无统计学意义（均有P〉0.05）。年龄、ALT、AST、Tbil及血清病毒载量对肝组织病理学改变均无影响（均有P〉0.05）。结论 白蛋白水平的下降和HBeAg阴性有助干预测肝组织病理学改变特征。Objective To analyze the influencing factors of liver histopathological change of normal or mild abnor- mal ALT in patients with chronic hepatitis B. Methods A total of 52 CHB patients with ALT≤2 × ULN were divided into two groups depending on liver tissue pathological inflammation or fibrosis level. The differences of age, blood biochemical index and virological index were compared. Results A lower albumin level was noted in the liver tissues with high fibrosis or inflammation （G/S ≥ 2 or higher） than that of low fibrosis or inflammation （G/S 〈 2） group （t = 2. 45, P = 0.018 ）. The level of ALT, AST and Tbil on HBeAg negative patients were all higher than those of HBeAg positive patients, but there was no statistical significance （ all P 〉 0. 05 ）. Age, ALT, AST, Tbil and viral load all had no effect on the change of liver tissue pathology （ all P 〉 0. 05 ）. Conclusions The low of albumin and negative HBeAg can help to predict the character- istics of liver tissue pathology change.

关 键 词：肝炎 乙型 慢性 组织 血清白蛋白 肝炎e抗原 乙型 

分 类 号：R512.62[医药卫生—内科学] R181.32[医药卫生—临床医学]