酒精及代谢性因素对慢乙肝患者肝纤维化的作用

发布时间：2018-03-02 06:10

本文关键词： 慢乙肝脂肪变性肝脏病理　出处：《新疆医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：了解单纯慢乙肝与慢乙肝合并脂肪变者的肝脏病变特点及临床差异,寻找与肝纤维化改变相关的危险因素。方法：分析275例HBsAg阳性患者的肝组织病理情况，将病例分为单纯乙肝组和乙肝合并脂肪变组,比较两组在年龄、腰围、尿酸、血脂方面的差异,分析各危险因素对肝脏纤维化的影响。并比较不同水平的脂肪变患者在相关指标及炎症纤维化水平上的差异，统计学处理采用SPSS统计软件，P＜0.05为差异有统计学意义。结果：275例乙肝患者中有脂肪变性者104例。慢乙肝合并脂肪肝组相比单纯慢乙肝组在腰围，尿酸，BMI，血脂水平上存在差异。年龄，炎症水平分级，饮酒以及HBeAg阴性状态是慢乙肝患者纤维化进展加重的独立危险因素；脂肪沉积对肝脏纤维化的影响为负相关。不同水平的脂肪变病人在性别，，腰围，尿酸，血脂方面有着明显差异（P 0.05），高水平的脂肪变有着更高水平的炎症。结论:血脂紊乱，肥胖等代谢综合征是肝细胞脂肪变性的主要原因，而与酒精无关，脂肪变会加重慢乙肝患者肝脏炎症程度。其中年龄，炎症水平, e抗原阴性状态，饮酒是CHB（Hepatitis B virus infection）患者肝组织纤维化进展相关的独立危险因素,但随着纤维化程度的加重,肝细胞脂肪变反而减轻.
[Abstract]:Objective: to investigate the characteristics and clinical differences of hepatic pathological changes in patients with chronic hepatitis B (CHB) and chronic hepatitis B (CHB) complicated with fatty change, and to find out the risk factors associated with hepatic fibrosis. Methods: the pathological changes of liver tissues in 275 patients with HBsAg positive were analyzed. The patients were divided into simple hepatitis B group and hepatitis B combined with fat group. The difference of age, waist circumference, uric acid, blood lipids between the two groups was compared. The effects of various risk factors on liver fibrosis were analyzed. Results there were 104 cases of fatty degeneration among 275 cases of hepatitis B. the waist circumference of chronic hepatitis B combined with fatty liver group was higher than that of chronic hepatitis B group (P < 0. 05). Age, grade of inflammation, alcohol consumption and HBeAg negative state were independent risk factors for exacerbation of fibrosis in patients with chronic hepatitis B. There were significant differences in sex, waist circumference, uric acid and blood lipids in patients with different levels of fat deposition, and there was a higher level of inflammation in high levels of fatty degeneration. Conclusion: dyslipidemia, hyperlipidemia, hyperlipidemia, hyperlipidemia, hyperlipidemia, hyperlipidemia, hyperlipidemia, and hyperlipidemia are associated with high levels of inflammation. Obesity and other metabolic syndrome are the main causes of hepatocyte steatosis, but are not related to alcohol. Fatty degeneration can aggravate the degree of liver inflammation in patients with chronic hepatitis B. among them, age, inflammation level, e antigen negative state, Alcohol consumption is an independent risk factor related to the progression of hepatic fibrosis in patients with CHB(Hepatitis B virus Infection.However, with the exacerbation of fibrosis, the fatty change of hepatocytes decreases.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.62

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