慢性乙型肝炎与慢性丙型肝炎患者临床和肝组织病理学特征分析  

Comparison of clinical features and histopathological activity index between patients with chronic hepatitis B and chronic hepatitis C

作　　者：蒋奕 刘冰[1] Jiang Yi;Liu Bing(Department of Infectious Diseases,404TH Hospital, Second Affiliated Hospital,North Sichuan Medical College,Mianyang 621000,Sichuan Province,China)

机构地区：[1]川北医学院第二附属医院/绵阳404医院感染病科,四川省绵阳市621000

出　　处：《实用肝脏病杂志》2019年第2期188-191,共4页Journal of Practical Hepatology

摘　　要：目的分析慢性乙型肝炎(CHB)与慢性丙型肝炎(CHC)患者临床特征及肝组织病理学表现的差异。方法 2013年～2017年我院诊治的CHB患者300例和CHC患者100例,收集临床资料并行肝活检组织病理学检查。结果本组资料显示,CHC患者年龄显著大于【(47.6±12.8)岁对(36.3±9.7)岁】、病程显著长于【(13.1±0.9)年对(6.2±1.8)年】、基础疾病显著多于(39.0%对18.7%)、经血感染显著多于(63.0%对36.7%)、母婴传播显著少于(3.0%对29.7%)、吸毒感染显著多于(40.0%对7.0%)和性传播显著少于(14.0%对26.7%)CHB患者(P<0.05);CHB患者血清ALT水平为(76.5±10.8) U/L,AST水平为(111.2±21.3) U/L,与CHC患者的【(105.2±20.8) U/L和(98.3±20.1) U/L】比,差异显著(P<0.05);CHC患者肝组织炎症分级>G2者为83.0%,显著高于CHB患者的48.7%(P<0.05),而肝纤维化分期>S2者为65.0%,也显著高于CHB患者的28.3%(P<0.05)。结论CHC患者由于病程长,发病隐匿,肝组织损伤更明显,需要积极的治疗。Objective To compare the clinical and histopathological features in patients with chronic hepatitis B(CHB)and chronic hepatitis C(CHC).Methods The clinical data of 300 patients with CHB and 100 patients with CHC in our hospital between 2013 and 2017 were collected and analyzed retrospectively.The liver biopsies were performed in all the cases.Results The materials in our series indicated that the age was older【(47.6±12.8)yr vs.(36.3±9.7)yr】,the illness period was longer【(13.1±0.9)yr vs.(6.2±1.8)yr】,underlying disease was more multiple(39.0%vs.18.7%),blood-borne infection was more common(63.0%vs.36.7%),mother-to-infant vertical transmission was more less(3.0%vs.29.7%),intravenous infection was more common(40.0%vs.7.0%)and sexual transmitted infection was more less(14.0%vs.26.7%)than in patients with CHB(P<0.05);serum ALT level was(76.5±10.8)U/L and serum AST level was(111.2±21.3)U/L in patients with CHB,significantly different as compared to【(105.2±20.8)U/L and(98.3±20.1)U/L】in patients with CHC(P<0.05);the hepatic histopathological examination showed that>G2 hepatic activity(HAI)index in patients with CHC was 83.0%,much higher than 48.7%(P<0.05)in patients with CHB,and>S2 liver fibrosis was 65.0%,also significantly higher than 28.3%(P<0.05)in patients with CHB.Conclusion There are many clinical and histopathological differences between patients with CHC and with CHB,and severe liver injuries and fibrosis might be more common in patients with CHC due to longer infection periods,which needs more medical interventions.

关 键 词：慢性乙型肝炎 慢性丙型肝炎 临床特征 组织病理学 

分 类 号：R512.62[医药卫生—内科学]