低ALT水平的慢性HBV感染者血清HBsAg水平与肝组织学的相关性  

Relationship between serum HBsAg level and liver histological features in chronic HBV infection patients with low ALT levels

作　　者：陈学福[1,2] 陈小苹[1,2] 马晓军[1,2] 黄晶[1,2] 罗晓丹[1,2] 廖金瑶 岑爱群[1,2] 

机构地区：[1]广东省人民医院感染科 [2]广东省医学科学院,广州510080

出　　处：《临床肝胆病杂志》2015年第10期1688-1691,共4页Journal of Clinical Hepatology

基　　金：广东省科技计划项目(2011B031800150)

摘　　要：目的通过分析低ALT水平慢性HBV感染者血清HBs Ag水平与肝组织炎症分级及纤维化分期的关系,探讨影响肝组织学的相关因素。方法收集2010年1月-2013年12月在广东省人民医院就诊的慢性HBV感染者511例,检测肝组织学、血清HBs Ag定量、HBV DNA定量。正态分布的计量资料两组间比较采用t检验,非正态分布的资料多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Nemeny检验。计数资料组间比较采用χ2检验,采用Spearman等级相关分析法判断HBs Ag水平与肝组织炎症分级和纤维化分期的相关性。结果 511例患者有不同程度肝组织异常。年龄≥40岁组HBe Ag阳性率、HBs Ag定量、HBV DNA定量均低于年龄<40岁组,差异均有统计学意义(统计值分别为86.80、2.99、7.25,P值分别为<0.000 1、0.003、0.000 1)。不同年龄组肝组织炎症分级和纤维化分期的分布差异有统计学意义(χ2值分别为70.03、61.92,P值均<0.000 1)。Spearman等级相关分析结果显示,HBe Ag阳性和HBe Ag阴性患者,HBs Ag水平与肝脏炎症分级及纤维化分期均呈负相关关系(r值分别为-0.245、-1.51、-0.153、-0.181,P值分别为<0.000 1、0.019、0.012、0.005)。结论低ALT水平慢性HBV感染者年龄是影响肝脏组织学进展的重要因素之一,且HBs Ag水平与肝组织炎症分级和纤维化分期均呈负相关关系,提示HBs Ag水平可作为此类患者无创性判断肝脏组织学状态的一项重要指标。Objective To investigate the factors influencing the liver histological features in chronic hepatitis B virus （HBV） infection pa- tients with low alanine transaminase （ALT） levels by analyzing the relationship of serum hepatitis B surface antigen （HBsAg） level with liver inflammation grade and fibrosis stage. Methods A total of 511 HBV infection patients admitted to our hospital from December 2010 to De- cember 2013 were studied. The liver histological features, serum HBsAg level, and HBV DNA copy number were examined. Comparison of categorical data between different groups was made by ehi - square test, comparison of continuous data following the nm＇mal distribution was made by t test, and comparison of continuous data not following the normal distribution was made by Kruskal - Wallis H test. The relation- ship of serum HBsAg level with liver inflammation grade and fibrosis stage was determined by Spearman＇s rank correlation analysis. Results All patients showed different degrees of hepatic histological abnormalities. The group aged more than or equal to 40 years had significantly lower HBeAg positive rate, HBsAg level, and HBV DNA copy number compared with the group aged less than 40 years （X2 = 86. 8, P 〈 0. 000 l ; t = 2.99, P = 0. 003 ; t = 7.25, P 〈 0. 000 1 ）. The groups with different ages had significant differences in liver inflammation grade and fibrosis stage （X2 =70.03, P 〈0. 000 1 ; A,2 =61.92, P 〈0. 000 1 ）. The Spearman＇s rank correlation analysis indicated that in both HBeAg -positive and -negative patients HBsAg level was negatively correlated with liver inflammation grade （r = -0. 245, P 〈 0. 000 1 ; r = - 1.51, P =0. 019） and fibrosis stage （r = -0. 153, P =0. 012; r = -0. 181, P =0. 005）. Conclusion Age is one of the important factors influencing the liver histological progression in chronic ttBV infection patients with low ALT levels. HBsAg level is negatively correla- ted with liver inflammation grade and fibrosis stage in chronic HBV infection p

关 键 词：肝炎 乙型 慢性 肝炎表面抗原 乙型 丙氨酸转氨酶 组织学 

分 类 号：R512.62[医药卫生—内科学]