HBeAg阴性慢性乙型肝炎患者肝脏病理改变及相关因素分析

发布时间：2018-01-23 03:27

  本文关键词： 肝炎 乙型 慢性 肝脏病理 HBe抗原　出处：《实用医学杂志》2015年16期 　论文类型：期刊论文

【摘要】：目的:探讨HBe Ag阴性的慢性乙型肝炎(CHB)患者的肝脏病理特点及其相关因素。方法:选择134例符合抗病毒治疗条件的HBe Ag阴性的CHB患者,行肝穿刺活检,常规苏木素-伊红染色及嗜银染色后,采用改良的Knodell HAI评分系统进行病理分析,并检测患者血清中丙氨酸氨基转移酶(ALT)、HBV DNA、乙型肝炎血清标志物以及乙型肝炎病毒基因型。均数比较采用t检验和方差分析,非参统计采用Kruskal-Wallis检验,用多元线性回归方法分析与肝脏炎症活动和纤维化相关的因素。结果 :134例HBe Ag阴性CHB患者炎症活动指数(HAI)按轻度(4~8分)、中度(9~12)和重度(13~18)炎症分组,3组中病例数分别为36例(26.9%)、35例(26.1%)、63例(47.0%)。纤维化评分3分和≥3分的病例数分别为25例(18.7%)和109例(81.3%)。患者血清ALT水平和肝脏纤维化是肝脏炎症活动度的相关因素(t=6.687,P0.01;t=3.478,P0.01);而患者年龄和肝脏炎症活动度是肝脏纤维化的相关因素(t=3.587,P0.01;t=7.136,P0.01)。患者性别、乙型肝炎病毒载量、乙型肝炎病毒基因型和HBe Ab状态与肝脏病理改变无明显相关。结论:本研究HBe Ag阴性的CHB患者中,肝脏病理改变以中、重度肝炎居多,患者血清ALT水平越高,肝脏炎症活动越重,患者年龄越大,肝脏纤维化程度越重。
[Abstract]:Objective: to study the HBe Ag negative chronic hepatitis B (CHB). Methods: 134 patients with HBe Ag negative CHB who met the condition of antiviral therapy were selected. Liver biopsy, routine hematoxylin eosin staining and argyrophilic staining were performed, and pathological analysis was performed with the improved Knodell HAI scoring system. The HBV DNA, HBV markers and HBV genotypes in serum of patients with alanine aminotransferase (alt) were detected. T test and ANOVA were used to compare the mean values. Kruskal-Wallis test was used for nonparametric statistics. Multivariate linear regression method was used to analyze the factors related to liver inflammation and fibrosis. Results the inflammatory activity index (HBe) of 134patients with HBe Ag negative CHB was 4 ~ 8 points. The number of cases in the 3 groups were 36 cases and 35 cases were 26. 1% respectively. The number of cases with fibrosis score of 3 and 鈮，

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