免疫耐受期慢性乙型肝炎患者的肝组织学特征及治疗现状  

Advances on liver histology and therapy of chronic hepatitis B patients in immune tolerance phase

作　　者：郭文敏[1] 李红[1] Guo Wenmin;Li Hong(Department of Infection Disease,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院感染病科,太原030001

出　　处：《国际流行病学传染病学杂志》2021年第3期247-250,共4页International Journal of Epidemiology and Infectious Disease

基　　金：社会公益研究专项计划(TQGB20180387)。

摘　　要：抗病毒治疗是目前慢性乙型肝炎(CHB)患者防止疾病进展最有效的治疗方式,准确把握治疗时机尤为重要。ALT升高被认为是持续性肝炎活动进展的重要危险因素,也是决定CHB患者抗病毒治疗的重要时间节点。然而,对于ALT持续正常的慢性HBV感染者(免疫耐受期CHB患者)是否需要抗病毒治疗一直存有争议。近年来研究报道发现,这类患者存在相当比例的明显肝坏死性炎症和肝纤维化,抗病毒治疗能部分降低其发生肝纤维化和肝细胞癌的风险。本文就以上内容作一综述。Antiviral therapy is the most effective way to prevent disease progression in patients with chronic hepatitis B(CHB),particularly the timing of treatment.Elevated ALT is an important risk factor for the progression of persistent hepatitis activity and an important indicator for CHB patients to start antiviral therapy.However,it has been controversial whether CHB patients with normal ALT(CHB patients in immune tolerance phase)need antiviral treatment.In recent years,studies have reported that a considerable proportion of these patients has obvious liver necrotizing inflammation and fibrosis,and antiviral therapy may reduce the risk of liver fibrosis progression and hepatocellular carcinoma.This topic is summarized in this paper.

关 键 词：肝炎病毒 乙型 丙氨酸氨基转移酶 免疫耐受 

分 类 号：R512.62[医药卫生—内科学]