慢性HBV感染者肝组织学影响因素的分析

发布时间：2018-03-21 07:26

  本文选题：肝炎　切入点：乙型　出处：《安徽医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的： 通过对慢性乙型肝炎病毒感染者行肝组织学检查，分析慢性乙型肝炎病毒感染者肝脏组织学影响因素。 方法: 本研究收集了从2010年3月到2011年8月在安徽医科大学第一附属医院感染科住院并进行肝组织病理学检查的129例慢性HBV感染者资料。调查入选时患者一般情况、肝功能、乙肝病毒学标志物、乙肝病毒复制量等。所有病例均在B超引导下进行肝穿刺病理活检，并进行肝组织炎症活动度(G)分度及纤维化程度分期(S)。分析谷丙转氨酶（ALT）、乙型肝炎核心相关抗原（HBeAg）、乙肝病毒脱氧核糖核酸（HBV DNA）、年龄及性别与肝组织病理的相关性。 研究结果： 1.129例患者中，炎症活动度分级为G1、G2、G3和G4者依次为80、43、3和3例，，分别占62.0%、33.3%、2.3%和2.3%；纤维化分级为S0、S1、S2、S3和S4者依次为11、50、39、16和13例，分别占8.5%、38.8%、30.2%、12.4%和10.1%；其到G2/S2及以上共72例，占55.8%。 2.肝脏的炎症活动度和纤维化程度随血清ALT的增高而加重，正常ALT组（ALT＜1×ULN）、ALT轻度升高组（1×ULN≤ALT＜2×ULN）、ALT明显升高组（ALT≥2×ULN）三组之间比较，差异有统计学意义。 3.在ALT＜2×ULN组中，≥35岁年龄层患者肝组织学≥G2/S2者的比例高于＜35岁者，差异有统计学意义(χ~2=10.71，P＜0.05；χ~2=8.93，P＜0.05)。而ALT明显升高组中，两个年龄层≥G2/S2者的比例比较，差异无统计学意义。 4.血清HBV DNA、HBeAg状态及性别与肝脏组织学改变程度没有显著性差别。 结论： HBeAg状态及HBV DNA水平不能准确反应慢性HBV感染者的肝组织病变程度，患者ALT、年龄水平可以作为慢性HBV感染者肝组织病变程度的参考指标，但不能依靠单一生化指标反应肝组织病变程度。对ALT＜2×ULN的35岁以上慢性HBV感染患者应考虑进行肝脏活检，特别是年龄较大者。
[Abstract]:Objective:. The influencing factors of liver histology in patients with chronic hepatitis B virus (HBV) were analyzed by means of liver histology examination. Methods:. From March 2010 to August 2011, the data of 129 patients with chronic HBV infection who were hospitalized in the infection Department of the first affiliated Hospital of Anhui Medical University and examined by liver histopathology were collected. Hepatitis B virological markers, hepatitis B virus replication, etc. All cases were performed liver biopsy under the guidance of B-ultrasound, The relationship between alt, HBeAg, HBV DNA DNA, age, sex and liver pathology was analyzed in this paper. The liver tissue inflammation activity and fibrosis degree were divided into three groups: alanine aminotransferase (alt), hepatitis B core antigen (HBeAg), hepatitis B virus DNA (HBV DNA), age and sex. Results of the study:. 1.Among 129 patients, the inflammatory activity grade of G1G2OG3 and G4 were 8043K3 and 3, respectively, accounting for 63. 0% and 2. 3%, respectively, and the fibrosis grades of S0 S1, S2, S2, S3 and S4 were 11503916 and 13, accounting for 8. 5% and 10. 1%, respectively, and there were 72 cases with G2 / S 2 and above, accounting for 55.8B. 2. The degree of inflammatory activity and fibrosis of liver increased with the increase of serum ALT. There was a significant difference among the three groups: the alt < 1 脳 ULN 鈮

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