ALT大致正常的CHB患者肝组织炎症活动度相关因素分析

Analysis on Inflammatory Activity in Liver Tissue in Chronic Hepatitis B with Normal ALT and Its Correlation Factors

【目的】了解血清谷丙转氨酶（ALT）大致正常的慢性乙型肝炎（CHB）肝组织炎症活动度（G）改变情况与各因素的关系。【方法】对本院826例血清ALT大致正常[ALT〈2倍正常值上限（ULN）]的CHB患者肝组织炎症活动度改变与ALT、HBeAg状态、年龄进行比较分析。【结果】ALT为1—2×ULN的肝组织炎症活动度G2及以上者显著高于ALT〈1×ULN者（P〈0．01）；HbeAg状态与肝组织炎症活动度无关（P〉0．05）；年龄与肝组织炎症活动度改变有密切关系，差异有显著性（P〈0．01）。【结论】ALT大致正常的CHB肝组织炎症活动度与ALT水平、年龄有关，与HBeAg状态无关，是否需要抗病毒治疗应根据肝脏活检组织学改变情况来决定。

[Objective[To understand the changes of inflammatory activity（G） in liver tissue of chronic hepatitis B（CHB） with normal serum alanine aminotransferase （ALT） and their relationship with various factors. [Methods] A total of 826 CHB patients with normal ALT [〈G2 times of the upper limit of normal （ULN）] in our hospital were enrolled. The changes of inflammatory activity in liver tissue, ALT, HBeAg status and the age of CHB patients were comparatively analyzed. [Results] The inflammatory activity in liver tissue of CHB patients with ALT for 1-2×ULN was significantly higher than that with ALT G1 × ULN （ P〈0.01）. HBeAg state of liver tissue was not related to inflammatory activity （ P〉0.05）. The age was closely related to the changes in inflammatory activity, and the difference was statistically significant （ P〈0. 01）. [Conclusion] Inflammatory activity in liver tissue of CHB patients with normal ALT is related to the level of ALT and age, but not correlated to HBeAg status. Antiviral therapy should be decided on the basis of histological changes of liver biopsy.