【摘要】 【目的】探讨慢性乙型肝炎(CHB)合并非酒精性脂肪性肝病(NAFLD)的临床和病理特征。【方法】对56例CHB合并NAFLD的患者及63例单纯CHB患者的一般资料、生化学指标、病毒学指标和部分患者的肝组织学结果进行分析、比较。【结果】CHB合并NAFLD的患者体重指数、Υ-谷氨酰转肽酶(γ-GGT)、甘油三酯、胆固醇水平高于单纯的CHB患者,CHB合并NAFLD的患者病毒负荷低于对照组、组织学上炎症程度及纤维化程度多数较轻。【结论】临床上对肥胖者、合并高脂血症者和-γGGT异常升高者需进行肝脏B超筛查NAFLD,如有条件可进行肝穿刺活检。HBV与NAFLD无直接关系,丙氨酸氨基转移酶(ALT)升高可能为NAFLD的结果,考虑抗病毒治疗宜慎重。更多还原

【Abstract】 【Objective】 To investigate clinical and pathological features of chronic hepatitis B(CHB) with nonalcoholic fatty liver disease(NAFLD).【Methods】 The clinical and pathological data of 63 cases of CHB and 56 cases of CHB with NAFLD were analyzed and compared.【Results】 The body mass index(BMI),plasmaγ-glutamyltransferase(γ-GGT),triglyeride(TG),cholesterol(CHOL) of CHB patients with NAFLD were higher than those of CHB patients.The viral load in CHB patients with NAFLD was lower than that of CHB patients.The degree of liver inflammation and fibrosis was mild in most of the cases.【Conclusion】 CHB patients with high BMI,γ-GGT,TG,CHOL value should be screened for NAFLD with B ultrasound,even liver biopsy.High ALT value may be caused by NAFLD other than CHB.Antiviral treatment should not start before careful consideration.更多还原