乙肝与丙肝病毒感染患者肝脏病理特点比较

Comparison of liver pathological characteristics between hepatitis B and hepatitis C virus infection patients

目的 比较乙型肝炎与丙型肝炎感染者肝脏病理特点.方法 选取2014年4月至2017年4月接受肝组织活检的慢性乙型肝炎患者134例为乙肝组,同期慢性丙型肝炎患者54例为丙肝组.采用雅培i2000?全自动化学发光免疫分析仪检测患者丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST);采用快速经皮穿刺活检术进行肝组织活检,由2名有经验的病理医师对所有标本进行审核诊断,确定患者肝组织炎症活动程度分级及肝组织纤维化分期.结果 丙肝组炎症分级≥G2的患者49例,乙肝组炎症分级≥G2的患者103例,两组比较差异有统计学意义(P<0.05).丙肝组患者炎症分级≥S2的患者40例,乙肝组患者炎症分级≥S2的患者75例,两组差异有统计学意义(P<0.05).乙肝组患者AST水平(135.68±75.26)U/L,高于丙肝组(65.02±24.18)U/L,差异有统计学意义(P<0.05);两组患者ALT水平差异均无统计学意义(P>0.05).结论 慢性丙型肝炎感染者肝组织炎症和纤维化水平高于慢性乙型肝炎感染者,具有一定的形态学鉴别诊断意义.

Objective To explore the differences between chronic hepatitis c infection and chronic hepatitis b infection in liver pathology.Method A total of 134 patients with chronic hepatitis b who received liver biopsy in our hospital from April 2014 to April 2017 were selected as hepatitis b group,and 54 patients with chronic hepatitis c were recorded as hepatitis c group.The levels of Alanine aminotransferase and Aspartate aminotransferase were detected by the Accpei I2000 automatic chemiluminescence immunoassay.Liver biopsy was performed with rapid percutaneous needle biopsy.All specimens were examined and diagnosed by two experienced pathologists to determine the degree of inflammatory activity in the liver tissue and the staging of hepatic fibrosis.Results In the hepatitis c group,there were 49 cases(90.74%)of patients with inflammatory grade≥G2.In the hepatitis b group,there were 103 cases(76.87%)of patients with inflammatory grade≥G2.The difference was statistically significant(P<0.05).The proportion of patients with inflammatory grade≥S2 in the hepatitis c group was 40(74.07%).The proportion of patients with inflammatory grade≥S2 in hepatitis b group was 75(55.97%).The difference was statistically significant(P<0.05).The AST level of the hepatitis b group was 135.68±75.26(U/L),and the AST level of the hepatitis c group was 65.02±24.18(U/L),and the data difference was statistically significant(P<0.05).There was no statistically significant difference in ALT level between the two groups(P>0.05).Conclusion The liver tissue inflammation and fibrosis level of patients with chronic hepatitis c are higher than those infected with chronic hepatitis b,and it has morphological differential diagnosis significance.