【摘要】 目的探讨不同年龄阶段慢性乙肝病毒感染者的肝组织病理特点。方法 288例慢性HBV感染者行1 s肝穿刺,标本均送免疫组化双标记及HE染色、Masson染色、网状纤维染色,进一步分析其病理特点。结果不同年龄根据谷丙转氨酶(ALT)水平[≤1正常值上限(ULN)、1~2 ULN、≥2 ULN]有抗病毒治疗指征比例:≤20岁组为18.2%、66.7%、80.0%;21-30岁组为18.8%、22.7%、57.1%;31-40岁组为37.0%、47.1%、84.6%;≥41岁组为44.2%、51.6%、71.4%。结论对于年龄>30岁的慢性乙肝病毒感染者,若ALT大于正常上限也应考虑抗病毒治疗,对于ALT正常但年龄大于30岁、ALT1-2ULN、有肝硬化肝癌家族史、合并肥胖或脂肪肝的慢性乙肝病毒感染者行肝穿刺可有效指导抗病毒治疗时机。更多还原

【Abstract】 Objective To investigate the pathological features of livers of patients at different ages with chronic hepatitis B virus( HBV) infection. Methods 288 cases of chronic HBV infection underwent a second liver biopsy. The specimens were detected with double labeling immunohistochemistry,HE staining,Masson staining,and reticular fiber staining for further analysis of the pathological features. Results According to ALT levels of different ages( ≤ 1 ULN,1 – 2 ULN,≥ 2 ULN),the rates of patients with antiviral treatment indications were18. 2%,66. 7%,80. 0% in Group A,18. 8%,22. 7%,57. 1% in Group B,37. 0%,47. 1 %,84. 6% in Group C,and 44. 2%,51. 6%,71. 4% in Group D. Conclusion For patients at age > 30,antiviral therapy should be considered if their ALT is greater than the upper limit of normal value. For patients with normal ALT but older than 30 years old,patients with ALT value of 1 to 2 ULN,and patients with family history of liver cirrhosis or liver cancer,and those with HBV infection combined with obesity or fatty liver,liver biopsy can be performed to effectively guide the timing of antiretroviral therapy.更多还原