慢性HBsAg携带者及非活动性HBV感染状态的病理学研究

The pathological study of chronic HBsAg carriers and inactive HBV infectious state

目的观察临床诊断为慢性HBsAg携带者及病理诊断为非活动性HBV感染状态患者的临床病理特点。方法总结慢性HBsAg携带者41例、非活动性HBV感染状态患者65例的临床资料,通过HE、组织化学及免疫组织化学染色观察其肝穿刺组织切片的病理变化。结果慢性HBsAg携带者41例无明显异常的症状体征,各项肝功能检查基本正常;但肝穿组织病理检查仅有10例无明显病变,30例为轻度慢性乙型肝炎,1例为静止性肝硬化。非活动性HBV感染状态患者65例中,少数患者有较轻的肝功能异常改变;病理检查无明显炎症和纤维化。结论慢性HBsAg携带者主要是一组以轻度慢性乙型肝炎表现为主的患者,非活动性HBV感染状态患者也仅有轻度的肝功能异常;慢性HBsAg携带者及非活动性HBV感染状态是临床医师和病理医师对同一类病变的不同诊断用词,对其诊断应结合临床和病理资料综合判断。

Objective To observe the clinicopathological features of chronic HBsAg carriers diagnosed by clinicians and inactive HBV infectious states diagnosed by pathologists. Methods The clinicopathological and morphologic features （including HE staining, histology staining and immuno - histochemical staining） of 41 cases of chronic HBsAg carriers and 65 cases of inactive HBV infectious state were analyzed. Results Forty - one chronic HBsAg carriers presented no obvious abnormal symptoms, physical signs and liver function tests, But only 10 of them showed little morphologic changes, other 30 cases showing mild chronic hepatitis B, one inactive cirrhosis. Among 65 patients of inactive HBV infectious state with almost no inflammation and fibrosis in liver tissues only a few presented light abnormality of liver function tests. Condusion Most chronic HBsAg carriers actually represented patients with mild chronic hepatitis B. The patients with inactive HBV infectious state only had mild abnormality of liver function. These two diagnoses are same meaning used differently by clinicians and pathologists. So the right diagnoses can be made only combining clinical and pathological information.