高复制型慢性乙型肝炎血清HBV复制指标与肝脏病变关系的探讨

Discussion on the Relationship between the serum HEV Replication Marks and Hepatic Pathological Changes in the Chronic Hepatits B of High Replication Type

本文报道５５例高复制型慢性乙型肝炎患者血清ＨＢＶ复制指标与肝脏病变的关系。５５例均为血清ＨＢｓＡｇ、ＨＢｅＡｇ及抗－ＨＢｃ阳性，部分病例血清ＨＢｃＡｇ、ＤＮＡＰ、ＨＢＶ－ＤＮＡ阳性，均作肝穿活检，病理报告ＣＡＨ５例、ＣＬＨ９例、ＣＰＨ４１例，前二者组成Ａ组，代表病变活动组；ＣＰＨ称Ｂ组，代表病变稳定组。结果显示Ａ组各项肝脏病变在ＨＢＶ复制情况下检出率普遍高于Ｂ组；ＡＬＴ异常时肝脏各项病变检出率达８０％以上者Ａ组也多于Ｂ组，而且Ａ组出现４例碎片状坏死、Ｂ组则无，显示乙肝病毒复制程度与肝脏病变活动性、广泛程度、肝功能受损等情况密切相关，因而提示抗病毒治疗的必要性。

he relationship between the serum HBV replication marks and hepatic pathological changes wasreported in 55 cases of chronic hepatitis B of high replication type.55 cases were HBsAg,HBeAg andanti-HBc positive,some accompanied with HBcAg,DNAP or HBV-DNA positive.All cases had madeliver biopsy and pathological test.The pathological report was:CAH 5 casea,CLH 9 cases and CPH 41cases.The first two states became Group A,which represented pathological change active,CPH became Group B,which represented inactive,Under the HBV replication state,the examined rate of thehepetic pathological change in the Group A was commonly higher than G roup B. Under the ALT abnor-mal state,the examined rate up to 80% of some hepatic patliological changes in Group A was alsohigher than Group B,It also indicated that piecemeal necrosis appeared in the 4 cases of Group A,andnone in Group B,Combinin8 the above result,it ind icated that there was close relationship among theHBV repl ication degree,the activity and extension of the hepotic pathological changes and the liverfunction damage.Thus,the antiviral therapy is neceasery.