慢性乙型肝炎患者血生化指标与肝组织病理的相关性

The relevance of serum biochemical indices and pathological grading and staging in liver tissues of patients with chronic hepatitis B

目的评价慢性乙型肝炎患者血生化指标诊断肝组织炎症活动度与纤维化程度的临床价值。方法对205例慢性乙型肝炎患者活体肝穿刺的病理标本进行组织炎症活动度分级(G)和纤维化程度分期(S),并分别与同期检测的血清肝功能指标比较。结果血清TBIL、ALT、AST、GGT平均值随病理分级和分期的增加而逐渐升高,ALB、PTA则相反;与病理诊断比较,临床诊断的灵敏度分别为:轻度83.5%(81例),中度56.8%(46例),重度51.9%(14例)。结论血清TBIL、ALT、AST、GGT可反映慢性乙型肝炎肝组织炎症活动的程度;ALB、PTA是慢性乙型肝炎病变进展的指标。

Objective To evaluate the clinical value of serum biochemical indices in the diagnosis of the grade and stage of the liver tissues in chronic viral hepatitis B. Methods A total of 205 cases of chronic hepatitis B were included. Liver biopsy was performed to determine the grade and stage of the liver tissues. The levels of biochemical indices were simultaneously measured. Results The serum level of TBIL , ALT, AST, GGT increased as the grade and stage increased, but ALB and PTA decreased. The sensitivity of clinical diagnosis were 83.5% in mild, 56.8% in moderate and 51.9% in severe degree, respectively. Conclusions Serum TBIL, ALT, AST, GGT could reflect the activity degree of liver pathological changes.