【摘要】 目的通过分析肝功能正常的慢性HBV感染者肝组织炎症分级与临床及血清学指标间的关系,寻找影响肝组织炎症活动度≥G2的相关因素。方法对90例入选的患者进行肝穿刺活检并进行肝组织病理炎症分期(G0～4)和纤维化分期(S0～4),并同时测定临床和血清学指标。将肝组织学诊断为慢性乙型肝炎(CHB)的82例患者,以肝组织炎症分级≥G2和<G2分为两组,对两组患者的年龄、性别、HBeAg状态、HBV DNA定量、ALT等五项指标进行比较,并进行Logistic回归分析。结果 90例慢性HBV感染者均存在不同程度的肝组织损伤,其中8例(8.9%)已进展为肝硬化;其余82例CHB患者中,炎症分级≥G2者30例,占36.58%;纤维化分期≥S2者28例,占34.15%;年龄≥40岁者所占比例在肝组织炎症分级≥G2组高于分级<G2组,有统计学意义(P<0.01);年龄≥40岁后,其肝组织炎症分级增大为G2以上的危险度是40岁以下者的6倍。结论慢性HBV感染者大多存在不同程度的肝组织损伤,损伤以轻度为主,中重度损伤所占比例在1/3左右;对40岁及以上且肝功能正常的CHB患者,应引起高度重视,以防止病变的隐性进展。更多还原

【Abstract】 Objective By analyzing the relationship among liver inflammation grades and other related indices in chronic HBV-infected patients with normal liver function,to explore the possible clinical factors and serum markers influencing the inflammation grade ≥G2.Methods The liver biopsy was conducted in 90 chronic HBV infected patients in order to confirm the inflammation grades and fibrosis stages.Serum indices were tested at the same time.Among the 90 patients,82 of them were diagnosed as chronic hepatitis B(CHB).82 patients with CHB were divided into 2 groups according to the liver pathological examination as the inflammation grade ≥G2 and<G2.The patients’ age,sex,HBeAg,HBV DNA and ALT were compared between the two groups.Logistic regression was also conducted to find the respective contribution of the above factors to the inflammation grade ≥G2.Results All of the 90 chronic HBV infected patients had different liver injuries,8 of them(8.89%) had cirrhosis.Eighty two were diagnosed as CHB,among which,30 had inflammation grade ≥G2(36.58%);28 had fibrosis stage ≥S2(34.15%);age≥40 was a correlating factor with the liver inflammation grade ≥G2(P<0.01).Once the age≥40,the patients had a 6-fold risk of inflammation grade ≥G2 than<G2 group.Conclusion Chronic HBV infected patients may all have different liver injuries,with the minor injuries as the most,and the medium to severe injuries as one third.Special attentions should be paid to the CHB patients whose age is older than 40 and liver function is normal,in order to find the latent development of the liver injuries.更多还原