乙型肝炎病毒携带者的病理与临床特点

Liver histopathological and clinical features of HBV carriers

目的了解乙型肝炎病毒携带者（Asc）的肝脏组织病理学特点，探讨其临床特点。方法分析我院感染科34例乙型肝炎病毒携带者行经皮肝穿术取肝脏组织，研究肝脏组织炎症活动度及纤维化分级分期，同时检测血清HBV—DNA及HBV血清标记物，分析乙型肝炎病毒携带者肝脏组织学改变特点、与HBeAg及年龄的关系。结果34例乙型肝炎病毒携带者中G0S0 8例，G1S0 22例，G1S1 2例，C2S2 2例；以E抗原阳性与阴性分层分析，炎症活动度及纤维化程度在两组间差异无统计学意义；不同年龄组间，炎症活动度差异无统计学意义，但纤维化程度差异有统计学意义（X2=15．154，P〈0．05），纤维化程度高者分布于40岁以上年龄组中。结论多数乙型肝炎病毒携带者肝脏组织学有轻度炎症，不伴或伴有轻度肝纤维化，纤维化程度高者易发生于40岁以上年龄组中，炎症程度及纤维化程度与E抗原是否为阳性无关。

Objective To study liver histopathological and clinical features of hepatitis B virus carriers （Asc）. Methods The changes of liver were evaluated histopathologically in 34 Asc by transepidermal liver biopsy method. The liver tissue was dyed with haematoxylin- eosin（HE） staining for study of pathologic grading and staging of hepatic liver inflammation and fibrosis, HBV markers were detected by enzymelinked immunosorbent assay （ELISA） method. Serum HBV - DNA levels were measured by polymerase chain reaction （PCR） method. Analysed the liver histopathological features of HBV carriers,the relationships between the HBeAg positivity and degrees of liver histological changes were evaluated. The grades of liver necrosis/inflammation and fibrosis were compared between three age groups ： younger than 27 years,27 - 40 years, and older than 40 years. Results Of 34 carriers, there were 8 persons with G0S0, 22 persons with G1S0, 2 persons with G1S1,2 persons with G2 S2. The rate of pathologic grading and staging of hepatic liver inflammation and fibrosis was not significantly different in HBeAg（ ＋ ） groups and HBeAg （ - ） groups, the fibrosis was more severe in older 40 years groups. Conclusion The majority of our HBV carriers have liver inflammation and fibrosis. More severe histological changes were found in older than 40 year age group. Liver histopathological features of HBV carriers has no relationship with the E antigen.