慢性HBV感染肝脏病理变化和生化ALT及病毒学关系

Relationship among pathological changes in liver tissues and level of serum ALT, virology of patients with chronic HBV infection

目的探讨慢性HBV感染ALT、HBV DNA与肝脏病理的关系。方法对81例慢性HBV感染患者检测血清ALT、HBV DNA，并进行肝活检病理检查。结果肝脏炎症分级和纤维化分期与ALT明显相关（r值分别为0．683和0．419），与HBV DNA无相关性。随着肝脏炎症活动度和纤维化程度的加重，ALT有升高趋势（Х^2趋势值分别为25．81和12．012），HBV DNA无升高趋势，而随着HBV DNA的升高，肝脏炎症活动度和纤维化程度并无加重趋势。肝组织HBsAg、HBcAg阳性组与阴性组的ALT、HBV DNA差异无统计学意义。结论ALT与肝脏炎症活动度有明显相关性，仍是观察炎症变化的敏感指标，HBV DNA与肝组织炎症分级及纤维化分期无相关性。

Objective To study the relationship among pathological and immunohistochemical changes in liver tissue and alanine aminotransferase （ALT）, HBV DNA levels in the patients with HBV infection. Methods The serum ALT, HBV DNA levels, pathological and immunohistoehemistry examination of liver tissue were performed in 81 patients with chronic HBV infection. Results The correlation of liver inflammation grades or fibrosis stages and the serum ALT levels were observed （the correlation coefficient were 0.683 and 0.419, respectively）, but not the HBV DNA levels. Followed by the hepatic inflammation activity and fibrosis, the serum ALT levels was obviously elevated, but the serum HBV DNA levels was not. The serum ALT, HBV DNA levels between the hepatic HBsAg/HBcAg positive group and HBsAg/HBcAg negative group were not different. Conclusion The serum ALT levels had significant relationship with the hepatitis activity, and ALT could be helpful for assessing the hepatitis activity. There was not correlation between hepatic inflammation grades and fibrosis stages and the serum HBV DNA, as well as the expression of HBsAg/HBcAg in liver tissue.