100例丙氨酸氨基转移酶正常的慢乙肝病毒感染者的肝组织病理研究

Study of liver histopathology in 100 patients with chronic hepatitis B virus infection and with normal ALT levels.

目的探索100例丙氨酸氨基转移酶(ALT)正常的慢乙肝病毒感染者的肝组织病理改变影响的可能因素及ALT相应的正常界限。方法收集100份乙肝病毒携带者的血清和肝穿病理标本分别行生化、乙肝标记物、乙肝病毒DNA(HBVDNA)检测和常规HE染色,光镜下观察其病理变化并评分。结果26例肝脏组织学有显著改变,HBeAg状态、ALT水平这二种因素对慢乙肝病毒携带者肝组织病理有影响。结论目前ALT正常值上限应下调为宜;持续ALT正常的慢性HBV感染者,应将肝活检作为判断肝病活动性和是否抗病毒治疗的主要依据。

Objeetive To explore the factors ＇affecting pathological changes in the liver tissue of normal - ALT - level patients with chronic hepatitis B virus infection and the corresponding ALT boundary. Methods The serum of 100 patients were detected for HBV markers and HBV DNA level. Meanwhile the liver samples were observed to score by conventional HE stain and light microscopy. Results 26 cases of the liver tissue showed significant pathological changes, which might be affected by such three factors as antigen status, ALT levels and the age of patients. Conclusion The patients with normal ALT and with chronic hepatitis B virus infection should turn down the boundary of normal ALT and should take liver puncture to evaluate the activity of liver disease and the necessity of anti - virus treatmenl.