低病毒载量HBeAg阴性慢性乙型肝炎患者肝纤维化特征分析  

Analysis on liver fibrosis features of HBeAg negative CHB patients with low viremia

作　　者：刘启材[1] 林思炜 何浩岚[1] 廖宝林[1] 蔡卫平[1] 李俊彬[1] 

机构地区：[1]广州市第八人民医院感染科,广州市510060 [2]越秀区中医医院内三科,广州市510030

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第2期33-37,共5页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：广州地区艾滋病防治科普知识培训项目(No.2060702)

摘　　要：目的探讨低病毒载量HBeAg阴性慢性乙型肝炎（CHB）患者肝组织的病理特征。方法回顾性收集HBV DNA≤20 000 IU/ml、HBeAg阴性且行肝组织活检的CHB患者资料,分析其肝纤维化特征及实验室预测指标。结果共纳入194例患者,其中142例（73.2%）伴显著性肝纤维化。HBV DNA 2 000-20 000 IU/ml（95例）与HBV DNA〈2 000 IU/ml（99例）两组患者间比较,总体与分别在不同丙氨酸氨基转移酶（ALT）水平患者间显著性肝纤维化发生率差异均无统计学意义（P〉0.05）。ALT≤ULN（123例）与ALT〉ULN（71例）两组患者间比较,总体与分别在不同HBV DNA水平患者间显著性肝纤维化发生率均差异无统计学意义（P〉0.05）。Logistic回归分析结果显示,血小板水平与显著性肝纤维化相关（OR=0.987,95%CI：0.980-0.995,P〈0.001）。结论低水平病毒载量HBeAg阴性CHB患者显著性肝纤维化较常见,建议进行肝纤维化程度评估。Objective To explore the characteristics of liver fibrosis in HBeAg negative chronic hepatitis B（CHB） patients with low viremia.Methods The data of HBeAg negative CHB patients with HBV DNA ≤ 20 000 IU/ml and liver biopsy were collected,retrospectively,while the fibrosis characteristics and associated biomarkers of the patients were analyzed,respectively.Results Total of 194 patients were included,among whom 142 patients（73.2%） had significant liver fibrosis.Comparison between patients with HBV DNA 2 000-20 000 IU/ml（n = 95） and patients with HBV DNA 2 000 IU/ml（n = 99）,there were no differences in the frequency of significant liver fibrosis in all patients or according to different ALT levels respectively（P all 〉0.05）.Comparison between patients with ALT ≤ ULN（n = 123） and patients with ALT ULN（n = 71）,there were no differences in the frequency of significant liver fibrosis in all patients or according to different HBV DNA levels respectively（P all 〉0.05）.Logistic regression analysis indicated that the PLT level was associated with significant liver fibrosis（OR：0.987,95%CI：0.980-0.995,P 〈0.001）.Conclusions Significant liver fibrosis is common in HBeAg negative CHB patients with low viremia,liver fibrosis assessment should be considered.

关 键 词：肝炎病毒 乙型 HBV DNA HBEAG阴性 肝纤维化 

分 类 号：R512.62[医药卫生—内科学]