30岁以上乙型肝炎病毒感染者肝组织病理学分级特点及与病毒载量和炎症因子的关系分析  

Analysis of the characteristics of liver histopathological grading and its relationship with viral load and inflammatory factors in patients over 30 years old with hepatitis B virus infection

作　　者：郭涛 刘芳 GUO Tao;LIU Fang(Department of Infection,Yichun Second People's Hospital,Yichun,Jiangxi,336000,China)

机构地区：[1]宜春市第二人民医院感染科,江西宜春336000

出　　处：《当代医学》2024年第7期152-155,共4页Contemporary Medicine

摘　　要：目的分析30岁以上乙型肝炎病毒(HBV)感染者肝组织病理学分级特点及与病毒载量和炎症因子的关系。方法选取2020年1月至2022年1月于宜春市第二人民医院诊治的80例30岁以上HBV感染患者作为研究对象,所有患者均在B超定位下进行肝活检,采用Metavir评分对肝组织炎症和纤维化程度进行评价,同时检测患者HBV-DNA病毒载量和炎症因子,并采用Spearman相关进行病理学分级与病毒载量和炎症因子的相关性分析。结果80例30岁以上HBV感染患者的肝组织病理学结果中,肝组织炎症分级:G0级0例,G1级49例,G2级27例,G3级3例,G4级1例;肝组织纤维化分级:S0级4例,S1级44例,S2级17例,S3级10例,S4级5例,其中肝组织炎症分级<G2级患者49例,≥G2级患者31例,肝组织纤维化程度分级<S2级患者48例(60.00%),≥S2级患者32例(40.00%);肝组织炎症分级<G2级患者的HBV-DNA、白细胞介素-12(IL-12)、白细胞介素-21(IL-21)、壳多糖酶3样蛋白1(CHI3L1)水平均低于肝组织炎症分级≥G2级患者,差异有统计学意义(P<0.05);肝组织纤维化分级<S2级患者的HBV-DNA、IL-12、IL-21、CHI3L1水平均低于肝组织纤维化分级≥S2级患者,差异均有统计学意义(P<0.05);Spearman相关分析结果显示,肝组织炎症分级与HBV-DNA病毒载量、IL-12、IL-21、CHI3L1水平呈正相关(r>0,P<0.05),肝组织纤维化分级与HBV-DNA病毒载量、IL-12、IL-21、CHI3L1水平呈正相关(r>0,P<0.05)。结论30岁以上HBV感染者的病毒载量和炎症因子水平在一定程度上可以反映肝组织炎症反应和纤维化程度。Objective To analyze the characteristics of liver histopathological grading and its relationship with viral load and inflammatory factors in patients over 30 years old with hepatitis B virus(HBV)infection.Methods 80 patients over 30 years old with HBV infection treated in Yichun Second People's Hospital from January 2020 to January 2022 were selected as the research subjects,all patients underwent liver biopsy under the localization of B-ultrasound,and the degree of liver inflammation and fibrosis was evaluated by Metavir score.At the same time,HBV-DNA viral load and inflammatory factors were detected in patients,and Spearman correlation was used to analyze the correlation between pathological grading and viral load and inflammatory factors.Results Among the liver histopathological results of 80 patients over 30 years old with HBV infection,the grades of liver inflammation:G00 cases,G149 cases,G227 cases,G33 cases,G41 case;liver fibrosis grades:S04 cases,S144 cases,S217 cases,S310 cases,S45 cases,of which 49 cases were liver inflammation grades<G2 and 31 cases(38.75%)were≥G2,48 cases(60.00%)with liver fibrosis grade<S2 and 32 cases with liver fibrosis grade≥S2.The levels of HBV-DNA,interleukin-12(IL-12),interleukin-21(IL-21)and chitinase 3-like protein 1(CHI3L1)in patients with liver inflammation grade<G2 were lower than those in patients with liver inflammation grade≥G2,and the differences were statistically significant(P<0.05);the levels of HBV-DNA,IL-12,IL-21 and CHI3L1 in patients with liver fibrosis grade<S2 were lower than those in patients with liver fibrosis grade≥S2,and the difference was statistically significant(P<0.05);Spearman correlation analysis showed that the inflammation grade of liver tissue was positively correlated with HBV-DNA viral load,IL-12,IL-21 and CHI3L1 levels(r>0,P<0.05),and the fibrosis grade of liver tissue was positively correlated with HBV-DNA viral load,IL-12,IL-21 and CHI3L1 levels(r>0,P<0.05).Conclusion the viral load and inflammatory factor level of HBV infected peopl

关 键 词：乙型肝炎病毒 病理学分级特点 病毒载量 炎症因子 

分 类 号：R512.62[医药卫生—内科学]