丙氨酸氨基转移酶持续正常的慢性乙肝感染者肝脏病理与临床相关性研究

目的分析丙氨酸氨基转移酶持续正常的慢性乙肝患者组织学改变情况。方法纳入201例丙氨酸氨基转移酶酶持续正常的慢性乙型肝炎患者,对肝组织学改变是否同HBeAg状态、HBV-DNA复制水平以及年龄存在相关性进行回顾性分析。结果在纳入的201例患者中,51.4%的患者炎症活动度≥G2,50.5%患者纤维化分期≥S2,HBeAg阴性患者较HBeAg阳性患者更易于发生显著的肝脏纤维化改变,HBV-DNA水平与肝组织炎症和纤维化程度无关,年龄与肝纤维化程度相关。结论 ALT持续正常慢性HBV感染者存在不同程度肝脏组织学改变,特别是年龄>40岁、HBeAg阴性且病毒复制活跃的感染者,更需密切观察肝脏病变改变情况。

The study of relationship between liver histological changes and clinical characters in the chronic hepatitis B patients with persistenuy normal alanine transaminase levels.

Objective To study the histological changes in livers of chronic hepatitis B(CHB) patients with persistently normal serum ALT levels(PNAL).Methods 201 CHB patients were included in this study.Their liver histological changes and the relationship between these changes and HBV-DNA,HBeAg statues and ages of patients were retrospectively analyzed.Results Among the 201 patients,the liver inflammation grade of 103 patients is higher than or equal to grade 2,the liver fibrosis stage of 101 patients id higher than or equal to stage 2.HBV-DNA level had any predictive meaning to the scores of the histological findings.However scores of histological changes increased sharply in parallel with an age increase of older than 49 years.Conclusion The liver histological changes in CHB patients with PNAL were varied.Liver biopsy should be considered in SHB patients with PNAL,especially those older than 40 years and HBeAg negative.